- Title
- Systematic review with meta-analysis: autoimmune hepatitis in pregnancy
- Creator
- El Jamaly, Hydar; Eslick, Guy D.; Weltman, Martin
- Relation
- Scandinavian Journal of Gastroenterology Vol. 56, Issue 10, p. 1194-1204
- Publisher Link
- http://dx.doi.org/10.1080/00365521.2021.1953127
- Publisher
- Taylor & Francis
- Resource Type
- journal article
- Date
- 2021
- Description
- Background: Maternal and fetal outcomes in pregnant patients with autoimmune hepatitis (AIH) has been largely unexplored. Aim: This meta-analysis aims to determine the level of evidence associated with both maternal and fetal outcomes in patients with AIH. Methods: We conducted a comprehensive literature search. The studies included AIH patients who had at least one pregnancy with a previously known or index presentation diagnosis of AIH. We used a random-effects model using odds ratios (OR) with 95% confidence intervals (CI). Results: Fourteen studies with 1452 AIH patients and with a total of 1556 gestations were included. Analysis revealed statistically significant increased likelihood of diabetes mellitus in the AIH group (OR: 5.73, 95% CI: 2.73–12.02; p < .001, n = 2) compared to controls. Fetal outcomes that indicated a statistically significant association with AIH included premature birth (OR: 2.20, 95% CI:1.66–2.91; p < .001, n = 3), small for gestational age (SGA) births (OR: 2.48, 95% CI:1.37–4.51; p = .003, n = 2) and low birth weight (LBW) (OR: 3.04, 95% CI:1.85–5.01; p < .001, n = 1). AIH pregnancies were significantly less likely to have a full-term birth (OR: 0.32, 95% CI:0.21–0.49; p < .001, n = 2). Conclusions: This meta-analysis provides the first pooled evidence that autoimmune hepatitis is associated with a substantial increase in maternal Pre-pregnancy and gestational diabetes mellitus, and that AIH females are more likely to have premature births, small for gestational age (SGA) births, and low birth weight (LBW) babies and a substantial decrease in full term birth compared to normal controls. This data is important for clinicians managing these patients before, during and after pregnancy.
- Subject
- autoimmune hepatitis; pregnancy; fetus; complications; diabetes mellitus; SDG 3; Sustainable Development Goals
- Identifier
- http://hdl.handle.net/1959.13/1471298
- Identifier
- uon:48637
- Identifier
- ISSN:0036-5521
- Language
- eng
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