Studies of primary sclerosing cholangitis and pregnancy outcomes have been limited in size and have been inadequate to rule out excess risks.
Dr Jonas Ludvigsson and colleagues from Sweden examined pregnancy outcomes among women with primary sclerosing cholangitis.
Women with primary sclerosing cholangitis were identified from inpatient and hospital-based outpatient data in the Swedish National Patient Register.
Through linkage with the Medical Birth Register, the researchers identified 229 singleton births, from 1987 through 2009, to women with primary sclerosing cholangitis before delivery.
These were compared with 2,304,863 births to women without a diagnosis of primary sclerosing cholangitis.
|Maternal primary sclerosing cholangitis was associated with a 3.6-fold increase in preterm birth |
|Clinical Gastroenterology & Hepatology|
The research team 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.
The team found that maternal primary sclerosing cholangitis was associated with a 3.6-fold increase in preterm birth as well as an increased risk of cesarean section.
The researchers found no increased risk based on analyses of the 5-minute Apgar score, small for gestational age, stillbirths, or neonatal deaths.
Maternal primary sclerosing cholangitis was not a risk factor for congenital abnormalities.
Stratification by inflammatory bowel disease status did not affect the risk estimates more than marginally.
Dr Ludvigsson's team concludes, "Maternal primary sclerosing cholangitis 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 primary sclerosing cholangitis."