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Good outcomes for pregnant women with primary biliary cirrhosis

This month's Clinical Gastroenterology & Hepatology reports good maternal and fetal outcomes for pregnant women with primary biliary cirrhosis.

News image

Up to 25% of patients diagnosed with primary biliary cirrhosis (PBC) are of childbearing age.

However, little is known about disease course during pregnancy.

Dr Gideon Hirschfield and colleagues from the United Kingdom performed a retrospective analysis of women with PBC during pregnancy using a representative large cohort of patients attending the Liver Center at Toronto Western hospital from 1979 through 2009.

Statistical analysis was performed by using R statistical software.

The researchers identified 32 women who either became pregnant after a diagnosis of PBC or in whom pregnancy led to diagnosis.

The team noted that liver biochemistry remained stable in 70% of patients throughout pregnancy.

91% of women had at least 1 successful live birth
Clinical Gastroenterology & Hepatology

However, 72% of patients had a flare in biochemical disease activity post partum, which was unrelated to biochemical disease activity before conception, or during the gestational period.

No adverse maternal events were observed during pregnancy or post partum, and only 6% of women developed progressive disease after delivery.

The research team noted that de novo pruritus developed during pregnancy in 53% of women, whereas itch that existed before conception worsened for 4 patients.

The team observed that 71% of women with pregnancy-related pruritus required symptom-specific therapy.

About 91% of women had at least 1 successful live birth.

The team observed that adverse fetal outcome was not influenced by biochemical disease activity before conception or during pregnancy.

Dr Hirschfield's team concludes, "Pregnancy in women with PBC is frequently symptomatic but mostly uneventful."

"The majority of women maintain stable liver biochemistry during pregnancy, although postpartum biochemical exacerbations are common."

Clin Gastroenterol Hepatol 2014: 12(7): 1179–1185.e1
01 July 2014

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