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Pregnancy and primary biliary cirrhosis: a case-control study.

Annarosa Floreani1, Chiara Infantolino, Irene Franceschet

  • 1Department of Surgery, Oncology and Gastroenterology - DiSCOG, University of Padova, Via Giustiniani, 2, 35128, Padova, Italy, annarosa.floreani@unipd.it.

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Women with primary biliary cirrhosis (PBC) can achieve successful pregnancies. While fertility rates are similar to healthy women, PBC patients face a slightly increased risk of childbirth complications, necessitating careful monitoring during pregnancy and delivery.

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Area of Science:

  • Hepatology
  • Autoimmune Diseases
  • Women's Health

Background:

  • Primary biliary cirrhosis (PBC) is a chronic autoimmune liver disease predominantly affecting women.
  • Disease onset often precedes clinical symptoms by many years, impacting reproductive health.
  • Identifying pregnancy risks and outcomes is crucial for women with PBC.

Purpose of the Study:

  • To analyze fertility in women with primary biliary cirrhosis (PBC).
  • To investigate pregnancy outcomes in PBC patients.
  • To assess the influence of pregnancy on the course of PBC.

Main Methods:

  • A case-controlled study included 233 female PBC patients and 367 healthy controls.
  • Matched participants based on age and conception history.
  • Compared pregnancy rates, outcomes, and disease progression between groups.

Main Results:

  • PBC patients had fewer pregnancies (1.91) compared to controls (2.73).
  • Similar rates of miscarriage, abortion, and delivery types, but lower cesarean rates in PBC patients.
  • PBC pregnancies had higher rates of pruritus, perinatal/postnatal complications, and deaths (2.7%).

Conclusions:

  • Successful pregnancy completion is achievable for women with PBC.
  • Pregnancy and delivery require vigilant monitoring due to potential childbirth complications.
  • Continuing ursodeoxycholic acid during pregnancy did not exacerbate PBC and supported favorable outcomes.