Increased risk of preterm birth in women with autoimmune hepatitis – a nationwide cohort study

Abstract

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.

Extrahepatic autoimmune diseases in patients with autoimmune hepatitis and their relatives: A Danish nationwide cohort study

“…Many studies found that patients with AIH are at increased risk for extrahepatic autoimmune diseases, and some of these studies found that their relatives are at increased risk for AIH and for extrahepatic autoimmune diseases, too . However, all the studies were small, many described self‐reported disease, and only one Swedish study included a comparison group from the general population, but it studied only pregnant women . We recently conducted a population‐based family cohort study with a comparison group from the general population, and we confirmed that AIH does accumulate in first‐degree relatives of patients with AIH, but the absolute risk is very low .…”

“…6 The notion of the autoimmune predisposition has some support in the literature, but the evidence remains weak. Many studies found that patients with AIH are at increased risk for extrahepatic autoimmune diseases, 3,[7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] and some of these studies found that their relatives are at increased risk for AIH 7,16,18 and for extrahepatic autoimmune diseases, too. [16][17][18][19][20]25 However, all the studies were small, many described self-reported disease, and only one Swedish study included a comparison group from the general population, but it studied only pregnant women.…”

Immunology of hepatic diseases during pregnancy

“…Clearly, some of the drugs used for second-line treatment of AIH such as mycophenolate mofetil (MMF) carry a high teratogenic potential and are contraindicated during pregnancy [200]. Although pregnancy appears safe for most patients [204,205], maternal morbidity and mortality may be increased, especially in patients with advanced liver cirrhosis and fatal complications have been reported [37,203]. Children born to mothers with AIH carry the risk of pre-term birth and low birth weight and the fetal loss rate may be increased, but there is no relevant signal for an increased risk of fetal malformations, even under treatment with azathioprine.…”

Pregnancy outcome in women undergoing liver biopsy during pregnancy: A nationwide population‐based cohort study

“…Women undergoing liver biopsy during pregnancy are unlikely to be healthy, and effects on the fetus and pregnancy outcome may be due to both the liver biopsy procedure and the indication for biopsy. This is because liver disease, including AFLP, hepatitis C, autoimmune hepatitis, and liver cirrhosis, may have a negative impact on pregnancy outcome. We approached this potential bias in various ways.…”