Maternal autoimmune hepatitis increases risk for adverse pregnancy-related outcomes
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Maternal autoimmune hepatitis correlated with five-fold higher odds of preterm birth; however, cirrhosis did not impact these odds, according to study results.
“Women with AIH have an increased risk of adverse pregnancy-related outcomes, and future studies are needed to determine mechanisms and whether specific interventions may help improve pregnancy-related outcomes,” Rajani Sharma, MD, MSc, of the division of digestive and liver diseases at Columbia University Irving Medical Center’s Center for Liver Disease and Transplantation in New York City, and colleagues wrote in Clinical Gastroenterology and Hepatology.
Sharma and colleagues performed a population-based cohort study in Sweden from 1992 to 2016 to identify 309 singleton births in women with autoimmune hepatitis (AIH). These births were matched with 1,532 births in women from the general population. Administrative coding and liver biopsies were used to diagnose AIH. Investigators determined adverse pregnancy outcomes using conditional logistic regression.
Out of 309 live births in women with AIH, 51 (16.7%) were preterm vs. 70 (4.6%) out of the 1,524 births in women from the general population (OR = 5.1; 95% CI, 3.29-7.92). There were similar odds when using sibling comparators, according to the researchers.
Investigators noted women with AIH with and without cirrhosis had comparable odds for preterm birth. There was a strong correlation between AIH and medically indicated preterm birth (OR = 13.01; 95% CI, 5.5-30.79). In addition, there was a correlation between AIH and low birth weight (OR = 5.31; 95% CI, 2.82-9.99) and low 5-min Apgar score (OR = 3.46; 95% CI, 1.14-10.49). However, there was no correlation with congenital malformations (OR = 1.14; 95% CI, 0.68-1.91), small for gestational age (OR = 1.04; 95% CI, 0.38-2.85), stillbirth (OR = 0.59; 95% CI, 0.02-18.88) or neonatal death (OR = 7.42; 95% CI, 0.65-84.25).
According to researchers, there was increased odds of cesarean section (OR = 1.44; 95% CI, 1.04-2) and preeclampsia (OR = 3.65; 95% CI, 2.01-6.64) in women with AIH. However, maternal AIH was not linked to gestational diabetes.
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