Pregnancy in autoimmune hepatitisoutcome and risk factors
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Pregnancy in autoimmune hepatitisoutcome and risk factors. / Schramm, Christoph; Herkel, Johannes; Beuers, Ulrich; Kanzler, Stephan; Galle, Peter R; Lohse, Ansgar W.
In: AM J GASTROENTEROL, Vol. 101, No. 3, 03.2006, p. 556-60.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Pregnancy in autoimmune hepatitisoutcome and risk factors
AU - Schramm, Christoph
AU - Herkel, Johannes
AU - Beuers, Ulrich
AU - Kanzler, Stephan
AU - Galle, Peter R
AU - Lohse, Ansgar W
PY - 2006/3
Y1 - 2006/3
N2 - OBJECTIVE: Autoimmune hepatitis (AIH) may influence pregnancy outcome and pregnancy may affect AIH. We aimed at analyzing the disease course in pregnant AIH patients and at identifying disease-related risk factors for adverse pregnancy outcome.PATIENTS AND METHODS: AIH patients with at least one pregnancy were identified at four liver units. The patients' records and the data obtained by detailed questionnaires were analyzed retrospectively. Forty-two pregnancies of 22 AIH patients were included.RESULTS: The rate of adverse pregnancy outcome was 26%; a medical explanation could be elucidated in only 4 of 11 pregnancies with adverse outcome. Of note, the 7 unexplained adverse pregnancy outcomes were highly associated with the presence of antibodies to SLA/LP (odds ratio 51; p < 0.003) and Ro/SSA (odds ratio 27; p < 0.02). Of 35 live births, 30 children developed normally over a mean observation period of nearly 5 yr. Eleven of these had been exposed to azathioprine in utero. The rate of serious maternal complications was 9% and a high rate (52%) of postpartum flares was noted.CONCLUSIONS: The presence of autoantibodies may be a risk factor for adverse pregnancy outcome in AIH patients. Close monitoring of both mother and fetus seems advisable due to a significant rate of maternal and fetal complications.
AB - OBJECTIVE: Autoimmune hepatitis (AIH) may influence pregnancy outcome and pregnancy may affect AIH. We aimed at analyzing the disease course in pregnant AIH patients and at identifying disease-related risk factors for adverse pregnancy outcome.PATIENTS AND METHODS: AIH patients with at least one pregnancy were identified at four liver units. The patients' records and the data obtained by detailed questionnaires were analyzed retrospectively. Forty-two pregnancies of 22 AIH patients were included.RESULTS: The rate of adverse pregnancy outcome was 26%; a medical explanation could be elucidated in only 4 of 11 pregnancies with adverse outcome. Of note, the 7 unexplained adverse pregnancy outcomes were highly associated with the presence of antibodies to SLA/LP (odds ratio 51; p < 0.003) and Ro/SSA (odds ratio 27; p < 0.02). Of 35 live births, 30 children developed normally over a mean observation period of nearly 5 yr. Eleven of these had been exposed to azathioprine in utero. The rate of serious maternal complications was 9% and a high rate (52%) of postpartum flares was noted.CONCLUSIONS: The presence of autoantibodies may be a risk factor for adverse pregnancy outcome in AIH patients. Close monitoring of both mother and fetus seems advisable due to a significant rate of maternal and fetal complications.
KW - Adolescent
KW - Adult
KW - Autoantibodies
KW - Biomarkers
KW - Female
KW - Hepatitis, Autoimmune
KW - Humans
KW - Infant, Newborn
KW - Liver Function Tests
KW - Predictive Value of Tests
KW - Pregnancy
KW - Pregnancy Complications
KW - Pregnancy Outcome
KW - Prognosis
KW - Retrospective Studies
KW - Risk Factors
KW - Stillbirth
KW - Journal Article
KW - Research Support, Non-U.S. Gov't
U2 - 10.1111/j.1572-0241.2006.00479.x
DO - 10.1111/j.1572-0241.2006.00479.x
M3 - SCORING: Journal article
C2 - 16464221
VL - 101
SP - 556
EP - 560
JO - AM J GASTROENTEROL
JF - AM J GASTROENTEROL
SN - 0002-9270
IS - 3
ER -