Journal
CLINICAL GASTROENTEROLOGY AND HEPATOLOGY
Volume 12, Issue 1, Pages 95-U141Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.cgh.2013.07.011
Keywords
Bile Duct Diseases; Child; Liver; Pregnancy; Primary Sclerosing Cholangitis
Categories
Funding
- Swedish Society of Medicine
- Swedish Research Council-Medicine [522-2A09-195]
- Fulbright Commission
- Wallenberg Foundation
- Stockholm County Council (ALF)
- Swedish Cancer Society
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BACKGROUND & AIMS: Studies of primary sclerosing cholangitis (PSC) and pregnancy outcomes have been limited in size and have been inadequate to rule out excess risks. We examined pregnancy outcomes among women with PSC. METHODS: Women with PSC were identified from inpatient and hospital-based outpatient data in the Swedish National Patient Register. Through linkage with the Medical Birth Register, we identified 229 singleton births, from 1987 through 2009, to women with PSC before delivery. These were compared with 2,304,863 births to women without a diagnosis of PSC. We used logistic regression, adjusted for maternal age, smoking, education, parity, and year of birth, to calculate adjusted prevalence odds ratios (aPORs) for adverse pregnancy outcomes. RESULTS: Maternal PSC was associated with a 3.63-fold increase in preterm birth (95% confidence interval [CI] for aPOR, 2.35-5.61) as well as an increased risk of cesarean section (aPOR, 2.18; 95% CI, 1.50-3.17). We found no increased risk based on analyses of the 5-minute Apgar score, small for gestational age, stillbirths, or neonatal deaths. Maternal PSC was not a risk factor for congenital abnormalities (aPOR, 1.12; 95% CI, 0.56-2.22). Stratification by inflammatory bowel disease status did not affect the risk estimates more than marginally. CONCLUSIONS: Maternal PSC is associated with both preterm birth and cesarean section but not with congenital malformation or other adverse outcomes of pregnancy. Pregnancy should not be discouraged in women with PSC.
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