Clinical and immunological characteristics in the newborn infants of mothers with organ transplants

Objective. To assess the health status of newborn infants of mothers with solid organ transplants who have received immunosuppressive therapy during pregnancy and to characterize the immune status of the infants. Subjects and methods. General clinical examination was made in pregnant women with solid organ transplants (n = 16) and their newborns (n = 16). Ultrasonography of the brain, abdominal organs, kidney, and heart were performed in all the infants. Flow cytometry was used to assess the subpopulation composition of lymphocytes in the umbilical and venous blood of newborns and in the venous blood of their mothers. Results. The babies born to women with organ transplants, who had received immunosuppressive therapy during pregnancy, had more frequently lower height and weight, lower gestational age, and increased frequency of early neonatal complications than the control group; however, the differences were statistically insignificant. As compared with the control group, the pregnant women with organ transplants during immunosuppressive therapy showed the signs of cellular immunity imbalance, which were manifested by decreases in the immunoregulatory index and the number of B lymphocytes and natural killer cells, by increases in the content of activated T lymphocytes and lymphocytes, ready for apoptosis. The umbilical cord blood of newborns in the study group displayed a decline in the relative content of B lymphocytes with no decreased immunoregulatory index, despite a significant increase in the percentage of CD3+CD4+ T lymphocytes. Conclusion. The infants born to women with organ transplants, whose pregnancy occurred while receiving immunosuppressive therapy, generally have a satisfactory health status during the early neonatal period and much less pronounced changes in their immune status, compared with those observed in their mothers. The absence of substantial health problems and changes in the immune status of the newborns of mothers with organ transplants makes it possible to count on a good quality of life in these children. However, further observations of a larger sample of infants are required to assess the long-term effects of intrauterine immunosuppressive therapy.

pregnancy, transplantation, immunosuppressive therapy, newborn, immunity