The outcome of pregnancy in kidney donors has generally been viewed to be 
favorable. We determined fetal and maternal outcomes in a large cohort of kidney 
donors. A total of 2102 women have donated a kidney at our institution; 1589 
donors responded to our pregnancy surveys; 1085 reported 3213 pregnancies and 
504 reported none. Fetal and maternal outcomes in postdonation pregnancies were 
comparable to published rates in the general population. Postdonation (vs. 
predonation) pregnancies were associated with a lower likelihood of full-term 
deliveries (73.7% vs. 84.6%, p = 0.0004) and a higher likelihood of fetal loss 
(19.2% vs. 11.3%, p < 0.0001). Postdonation pregnancies were also associated 
with a higher risk of gestational diabetes (2.7% vs. 0.7%, p = 0.0001), 
gestational hypertension (5.7% vs. 0.6%, p < 0.0001), proteinuria (4.3% vs. 
1.1%, p < 0.0001) and preeclampsia (5.5% vs. 0.8%, p < 0.0001). Women who had 
both pre- and post-donation pregnancies were also more likely to have these 
adverse maternal outcomes in their postdonation pregnancies. In this large 
survey of previous living donors in a single center, fetal and maternal outcomes 
and pregnancy outcomes after kidney donation were similar to those reported in 
the general population, but inferior to predonation pregnancy outcomes.