Pregnancy and childbirth in women with autoimmune hepatitis is safe, even in compensated cirrhosis

Abstract

Introduction Autoimmune hepatitis (AIH) is a liver disease that primarily affects women. Many become ill during childbearing age, and medication can be lifelong. Few studies exist on pregnancy outcome in women with AIH. Objectives The aim was to assess the outcome of women with AIH and their children during pregnancy and postpartum. Materials and methods Sixty-four women from a well-characterised cohort with AIH filled out a questionnaire with information about their disease, miscarriage/abortion, pregnancies and potential birth defects in 2012. In 2004, 106 women answered the same questionnaire and their results were analysed along with the new questionnaires. Results One hundred and thirty-eight women have completed the questionnaire and 100 children have been born by 58 women. Fifty-seven women (41%) had cirrhosis. In 84% of the pregnancies, the AIH was stable or milder, 32% had an increase in activity postpartum. The proportion of preterm births (before week 38) was 22%, caesarean sections 17%, malformations 3%, and two children died. Twenty-three women with cirrhosis had children after diagnosis of cirrhosis but without more complications than for non-cirrhotic mothers. However, they did have a higher prevalence of caesarean sections. Conclusion Pregnancy and childbirth in AIH appear to be safe for both child and mother, even in women with compensated liver cirrhosis.

Keywords:

• Abortion
• autoimmune
• hepatitis
• liver cirrhosis
• pregnancy
• pregnancy outcome
• spontaneous

Acknowledgements

We thank Vera Werner for inputting data and last but not least, to Åke Danielsson and Ole Suhr for their invaluable advice and assiduous support.

Declaration of interest

The study was supported by grants from Bengt Ihre’s fund, Umeå University, Lions in Umeå and Department of Medicine at Umeå University hospital. Meda AB supported the SILK meetings throughout the study.