The effect of pregnancy on cyclosporine levels in renal allograft patients

Objective: To assess the effects of pregnancy on cyclosporine levels in six renal allograft patients. Methods: Maternal demographic, laboratory, clinical, and perinatal outcome data were recorded in six pregnant women with previous renal allografts receiving cyclosporine immunosuppression. The cyclosporine and serum creatinine levels were measured before pregnancy, during each trimester, and postpartum. Results: The mean (standard deviation [SD]) maternal age was 29.1 (3.8) years. Parity ranged from 9 to 3. Mean serum creatinine levels tended to be lower during pregnancy than before or after, as did the mean cyclosporine levels. After adjusting for dose, five of six patients had declines in cyclosporine level during pregnancy. The mean (SD) gestational age at delivery was 37.5 (2.8) weeks with a mean (SD) birth weight of 2837 (538) g. Conclusion: Pregnancy in patients with renal allografts can lead to a substantial decline in cyclosporine levels. (C) 1997 by The American College of Obstetricians and Gynecologists.