Knut Stokkeland1,2, Jonas F Ludvigsson3,4, Rolf Hultcrantz2,5, Anders Ekbom6, Jonas Höijer7, Matteo Bottai7, Olof Stephansson6,8. 1. Department of Medicine, Visby Hospital, Visby, Sweden. 2. Gastroenterology and Hepatology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden. 3. Department of Pediatrics, Örebro University Hospital, Örebro, Sweden. 4. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. 5. Division of Hepatology, Karolinska Hospital, Stockholm, Sweden. 6. Clinical Epidemiology Unit, Department of Medicine, Karolinska Hospital and Institutet, Solna, Stockholm, Sweden. 7. Unit of Biostatistics, IMM, Karolinska Institutet, Stockholm, Sweden. 8. Department of Women's and Children's Health, Karolinska Hospital and Institutet, Stockholm, Sweden.
Abstract
BACKGROUND & AIMS: The aim of our study was to investigate the risks of pregnancy and childbirth complications in women with autoimmune hepatitis compared to the population controls. METHODS: In a nationwide cohort study of all pregnancies between 2006 and 2011 we investigated the risks of adverse pregnancy outcome in 171 births in women with diagnosed autoimmune hepatitis using the data from the Swedish Medical Birth and Patient Registries. Births to women without autoimmune hepatitis served as population controls (n = 576 642). Relative risks (RR) with 95% confidence intervals (CI) were calculated using Poisson regression models adjusting for potential confounders. RESULTS: Women with AIH had an increased risk of gestational diabetes (RR = 4.35, 95% CI 2.21-8.57), of preterm birth (RR = 3.21, 95% CI 1.97-4.92) and of low-birth-weight child (RR = 2.51, 95% CI 1.51-4.19). We found no statistically significant association between autoimmune hepatitis and pre-eclampsia, caesarean section, low 5-min Apgar score, small for gestational age birth, congenital malformation and neonatal mortality. CONCLUSIONS: Autoimmune hepatitis is a risk factor for adverse pregnancy outcomes. High quality prenatal and antenatal care is important for women with autoimmune hepatitis and their infants.
BACKGROUND & AIMS: The aim of our study was to investigate the risks of pregnancy and childbirth complications in women with autoimmune hepatitis compared to the population controls. METHODS: In a nationwide cohort study of all pregnancies between 2006 and 2011 we investigated the risks of adverse pregnancy outcome in 171 births in women with diagnosed autoimmune hepatitis using the data from the Swedish Medical Birth and Patient Registries. Births to women without autoimmune hepatitis served as population controls (n = 576 642). Relative risks (RR) with 95% confidence intervals (CI) were calculated using Poisson regression models adjusting for potential confounders. RESULTS:Women with AIH had an increased risk of gestational diabetes (RR = 4.35, 95% CI 2.21-8.57), of preterm birth (RR = 3.21, 95% CI 1.97-4.92) and of low-birth-weight child (RR = 2.51, 95% CI 1.51-4.19). We found no statistically significant association between autoimmune hepatitis and pre-eclampsia, caesarean section, low 5-min Apgar score, small for gestational age birth, congenital malformation and neonatal mortality. CONCLUSIONS:Autoimmune hepatitis is a risk factor for adverse pregnancy outcomes. High quality prenatal and antenatal care is important for women with autoimmune hepatitis and their infants.