Neonatal Outcomes after Uterus Transplantation: Dallas Uterus Transplant Study

Abstract

Objective Limited data are available on the outcome of infants born after uterus transplantation. Our aim was to describe the hospital course and laboratory findings in the first 2 months of life of the 12 infants born in the Dallas UtErus Transplant Study (DUETS).

Study Design Based on the trial protocol, information about infants was collected in a prospective fashion, including infant demographics, hospital course, and laboratory values.

Results Twelve infants were delivered, all by cesarean section, from 11 mothers who had undergone uterus transplantation (one mother had two pregnancies and delivered two babies). All pregnancies were singleton. The mothers received immunosuppressive therapy, and one had a rejection episode that was detected during pregnancy. The rejection episode resolved after steroid treatment. The infants had a median gestational age of 36^6/7 weeks (range: 30^6/7–38^0/7 weeks) and median birth weight of 2,920 g (range: 1,770–3,470 g). The lowest Apgar's score at 5 minutes was 8. All infants were appropriate size for gestational age. Two infants presented with bandemia but negative blood cultures. At 2 months of age, all infants achieved the developmental and behavioral milestones outlined by the American Academy of Pediatrics.

Conclusion The 12 infants born from mothers with uterus transplants had a neonatal course that reflected the gestational age at delivery. No baby was born with an identified malformation or organ dysfunction. Longer follow-up and a larger number of infants are needed to confirm these observations.

Key Points

• Normal fetal development after uterus transplantation.

• No baby was born with malformations or showed any organ dysfunction.

• At 2 months, all infants achieved appropriate developmental and behavioral milestones.

Keywords

uterus transplantation - immunosuppression - preterm birth - neonatal course - growth

Note

This study is registered with the clinical trial registration no.: NCT02656550 ( https://clinicaltrials.gov/ct2/show/NCT02656550 ).

Authors' Contributions

J.R.Y., G.T., and A.R.G. conceptualized and designed the study, collected data, drafted the initial manuscript, and reviewed and revised the manuscript. G.J.M., and J.B. participated in the transplant surgeries and revised the manuscript for intellectual content. R.T.G. collected data and revised the manuscript for intellectual content. L.Z. and J.K.P. performed in vitro fertilization, collected data, and revised the manuscript for intellectual content. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

Publication History

Received: 18 December 2020

Accepted: 24 February 2021

Article published online:
20 April 2021

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