TY - JOUR
T1 - Outcomes of pregnancies complicated by liver cirrhosis, portal hypertension, or esophageal varices
AU - Puljic, Anela
AU - Salati, Jennifer
AU - Doss, Amy
AU - Caughey, Aaron
N1 - Publisher Copyright:
© 2015 Informa UK Ltd.
PY - 2016/2/1
Y1 - 2016/2/1
N2 - Objective: To evaluate pregnancy outcomes in women with liver cirrhosis, portal hypertension, or esophageal varices.Study design: We analyzed a retrospective cohort of 2 284 218 pregnancies in 2005-2009 recorded in the California Birth Registry database. Utilizing ICD-9 codes we analyzed the following outcomes for liver cirrhosis, portal hypertension, or esophageal varices in pregnancy: preeclampsia (PET), preterm delivery (PTD; <37 weeks), cesarean section, low birth weight (LBW; <2500 g), small for gestational age (SGA; <10th percentile), neonatal death (NND), and postpartum hemorrhage (PPH).Results: Cirrhosis in pregnancy conferred an increased risk of PET, PTD, CS in multiparous women, LBW, and NND. Portal hypertension in pregnancy was associated with PTD, LBW, NND, and PPH. Non-bleeding esophageal varices in pregnancy were not associated with the outcomes assessed in a statistically significant manner. One case of bleeding esophageal varices was observed, resulting in PTD with a LBW infant. There were three cases of concomitant portal hypertension or concomitant esophageal varices with cirrhosis in pregnancy.Conclusion: Pregnancy in women with concomitant liver cirrhosis, portal hypertension, or esophageal varices can be successful. However, pregnancy outcomes are worse and may warrant closer antenatal monitoring and patient counseling. Cirrhosis in pregnancy with concomitant portal hypertension or esophageal varices is rare.
AB - Objective: To evaluate pregnancy outcomes in women with liver cirrhosis, portal hypertension, or esophageal varices.Study design: We analyzed a retrospective cohort of 2 284 218 pregnancies in 2005-2009 recorded in the California Birth Registry database. Utilizing ICD-9 codes we analyzed the following outcomes for liver cirrhosis, portal hypertension, or esophageal varices in pregnancy: preeclampsia (PET), preterm delivery (PTD; <37 weeks), cesarean section, low birth weight (LBW; <2500 g), small for gestational age (SGA; <10th percentile), neonatal death (NND), and postpartum hemorrhage (PPH).Results: Cirrhosis in pregnancy conferred an increased risk of PET, PTD, CS in multiparous women, LBW, and NND. Portal hypertension in pregnancy was associated with PTD, LBW, NND, and PPH. Non-bleeding esophageal varices in pregnancy were not associated with the outcomes assessed in a statistically significant manner. One case of bleeding esophageal varices was observed, resulting in PTD with a LBW infant. There were three cases of concomitant portal hypertension or concomitant esophageal varices with cirrhosis in pregnancy.Conclusion: Pregnancy in women with concomitant liver cirrhosis, portal hypertension, or esophageal varices can be successful. However, pregnancy outcomes are worse and may warrant closer antenatal monitoring and patient counseling. Cirrhosis in pregnancy with concomitant portal hypertension or esophageal varices is rare.
KW - Esophageal varices
KW - liver cirrhosis
KW - portal hypertension
KW - pregnancy outcomes
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U2 - 10.3109/14767058.2015.1009438
DO - 10.3109/14767058.2015.1009438
M3 - Article
C2 - 25655526
AN - SCOPUS:84951077638
SN - 1476-7058
VL - 29
SP - 506
EP - 509
JO - Journal of Maternal-Fetal and Neonatal Medicine
JF - Journal of Maternal-Fetal and Neonatal Medicine
IS - 3
ER -