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Primary biliary cholangitis in pregnancy:A systematic review with meta-analysis

Hepatobiliary & Pancreatic Diseases International 2022年第3期21卷 218-225页

作者： hydar el jamaly Guy D Eslick Martin Weltman Department of Gastroenterology and Hepatology Nepean HospitalPenrithNew South WalesAustralia Nepean Clinical School The University of SydneyPenrithNew South WalesAustralia NHMRC Centre for Research Excellence in Digestive Health Hunter Medical Research InstituteThe University of NewcastleNewcastleNew South WalesAustralia

Background: The outcomes and disease associations in pregnant women with primary biliary cholangitis(PBC) have not been largely explored. This study aimed to determine the level of evidence associated with maternal and fetal outcomes and other disease associations in female patients with PBC. Data sources:: A comprehensive literature search was conducted. Maternal and fetal outcomes were obtained from patients with a previous, current or subsequent diagnosis of PBC. A random-effects model was employed, using odds ratios(ORs) with 95% confidence intervals(CIs). Results: eleven studies, with 2179 female PBC patients were included. Pregnant women with PBC were significantly more likely to have a miscarriage(OR = 1.27, 95% CI: 1.02-1.58;P = 0.03), and a history of abortion(OR = 1.50, 95% CI: 1.09-2.07;P = 0.01), with absent heterogeneity( I 2 = 0%). PBC pregnant women were significantly more likely to deliver via vaginal birth(OR = 1.69, 95% CI: 1.33-2.14;P el heterogeneity( I^(2) elihood of lifetime smoking(OR = 1.95, 95% CI: 1.17-3.23;P = 0.01). Egger’s regression revealed no evidence of publication bias. Conclusions: This meta-analysis provides pooled evidence that a PBC pregnancy is associated with fetal morbidity and maternal lifestyle associations that may influence pregnancy outcomes. More studies are needed to establish disease associations that may directly affect pregnancy outcomes. These data are essential for clinicians managing these patients before, during or after pregnancy.

关键词： Pregnancy Fetal Maternal Primary biliary cholangitis Miscarriage

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