According to a new research presented at The Liver Meeting®, the pregnancy rates among females with chronic liver disease or following liver transplantation has risen over the past three decades. Also, the percentage of full?term pregnancies has increased considerably over the period, and most females had positive pregnancy outcomes.
The research has offered a multidisciplinary hepatology and obstetrics clinic for pregnant females with the chronic liver disease in response to an increasing global burden of liver disease and a rising percentage of females of reproductive age who have been detected with chronic liver disease or undergoing liver transplantation.
The liver disease is increasing worldwide and the total of females of reproductive age with liver disease has also risen. The presence of liver disease and/or liver transplant confers certain risks to pregnancy outcome. So, researchers wanted to assess the trends of pregnancy outcomes over the last 30 years, which would help to identify the predictors of successful outcomes in pregnancy and to improve pregnancy counselling in these women.
The team conducted a retrospective analysis of all pregnancies occurring in females with chronic liver disease or following liver transplantation. The researchers identified patients from a prospectively collated database and extracted the data from patient records. Then compared the results of these pregnancies in three different time periods: 1983? 1996, 1997?2006 and 2007?2017.
The results revealed that 327 conceptions occurred in 193 women. The cause of liver diseases in these patients included 35% with autoimmune hepatitis, 18% with metabolic/congenital liver disease, 7% with drug toxicity, 7% with primary biliary cirrhosis/primary sclerotic cholangitis, 6% with biliary atresia, 7% with seronegative liver failure, and 6% with viral hepatitis. Data were available for 313 conceptions for comparison.
The number of pregnancies increased over the three time periods, from 30 prior to 1997, to 102 between 1997 and 2006, and then to 181 since 2007. Corresponding live birth rates were 73%, 70% and 87%, respectively. Prematurity rates, or gestation of fewer than 37 weeks, reduced significantly over time. Rates of elective termination, miscarriages and stillbirths also decreased. Finally, for patients where data was available, cesarean section rates also decreased significantly.
The findings showed that the number of pregnancies has increased significantly over the time period. The rate of live births has improved, and the rate of premature births has reduced. The improvements in the outcomes are likely due to a combination of factors, such as the advances in both hepatological and obstetric care. Hence, the researchers suggest that the females would benefit from a multidisciplinary care approach.