Pregnancy Outcomes Among Women With Liver Cirrhosis [8OP

Abstract

INTRODUCTION: The objective of this study was to compare pregnancy outcomes among women whose pregnancy was complicated by cirrhosis of the liver to women without liver cirrhosis. METHODS: This was a retrospective cohort study of women diagnosed with liver cirrhosis prior to their pregnancy and women without cirrhosis between 2005-2015, in a single tertiary care center. Univariable comparisons of patients’ characteristics and pregnancy outcomes were conducted using chi-square or Fisher’s exact test for categorical data and student t-test for continuous measures. Multivariable logistic regression was done to determine independent association of liver cirrhosis and adverse obstetric outcomes. RESULTS: 31 women with cirrhosis were identified and compared to 124 controls. Most common etiology for liver cirrhosis was ETOH (29.0%), followed by primary biliary cirrhosis (22.7%). In univariable analysis, women with cirrhosis were more likely to be black (29.0% vs. 12.1%, p=0.03), have chronic hypertension (16.1% vs. 3.2%, p=0.006), and presence of fetal anomalies (9.7% vs. 0.0%, p < 0.001), preeclampsia (19.4% vs. 4.0%, p=0.003) fetal or neonatal demise (16.1% vs. 0.0%, p < 0.001) and small-for-gestational-age infant (16.1% vs. 4.8%, p=0.020). In multivariable analysis controlling for potential confounders, diagnosis of cirrhosis remained to be independently associated with preterm delivery and preeclampsia. CONCLUSION: Women whose pregnancy is complicated by liver cirrhosis are at higher risk for preterm delivery and preeclampsia.