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Published on: February 3, 2023
Maternal risk factors associated with offspring biliary atresia: population-based study
Ching-Min Chang1, Kuang-Che Kuo2, Wan-Hsuan Chen1
1Department of Pediatrics, Chiayi Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Chiayi, Taiwan.
Insights
Maternal type 2 diabetes and drug abuse increase the risk of biliary atresia (BA) in infants. Identifying maternal factors could make this serious liver disease preventable.
Area of Science:
- Pediatric Hepatology
- Neonatal Research
- Maternal Health
Background:
- Biliary atresia (BA) is a progressive, idiopathic, fibro-obliterative disease of the intra and extrahepatic biliary tree, leading to severe liver injury and death if untreated.
- The etiology and pathogenesis of BA remain unclear, with limited research on maternal factors.
- Few studies have investigated the association between maternal illness/drug use and the occurrence of BA in offspring.
Purpose of the Study:
- To investigate the association between maternal illness/drug use and the occurrence of biliary atresia (BA) in offspring.
- To identify specific maternal risk factors contributing to BA.
- To explore the potential for preventing BA through understanding maternal etiology.
Main Methods:
- Utilized data from Taiwan's Birth Certificate Application linked to the National Health Insurance Research Database and Taiwan Maternal and Child Health Database (2004-2017).
- Included 1,647,231 births, identifying 285 cases of biliary atresia (BA) based on diagnosis and procedure codes.
- Analyzed the association between maternal conditions and BA occurrence in offspring.
Main Results:
- Mothers with type 2 diabetes mellitus had a significantly higher rate of having BA children (Odds Ratio [OR] = 2.17, 95% Confidence Interval [CI] = 1.04-4.53).
- Maternal non-dependent drug abuse was also associated with a higher rate of BA in offspring (OR = 3.02, 95% CI = 1.34-6.78).
- These findings indicate a notable link between maternal factors and BA occurrence.
Conclusions:
- The occurrence of biliary atresia (BA) in offspring is potentially related to maternal illness and drug use.
- Maternal drug abuse and type 2 diabetes mellitus represent significant risk factors for BA.
- Identifying maternal etiology could pave the way for preventing biliary atresia.
Background:
Biliary atresia (BA) is a progressive, idiopathic, fibro-obliterative disease of the intra and extrahepatic biliary tree. If untreated, it results in severe liver injury and death. The etiology and pathogenesis of BA remain unclear. Few studies have investigated the association between maternal illness/drug use and the occurrence of BA in offspring.
Methods:
We used the data from the Birth Certificate Application of Taiwan and linked to National Health Insurance Research Database and Taiwan Maternal and Child Health Database for the years 2004 to 2017 (N = 1,647,231) on 2022/03, and identified BA cases according to diagnosis and procedure code. A total of 285 BA cases were identified.
Results:
Mothers with type 2 diabetes mellitus and non-dependent drug abuse had higher rates having BA children than non-BA children, with an odds ratio of 2.17 (95% confidence interval [CI] = 1.04-4.53) and OR: 3.02 (95% CI = 1.34-6.78), respectively.
Conclusion:
These results support the notion that BA occurrence is related to maternal reasons. Further studies should be designed to identify additional maternal and pregnancy risk factors and to understand the underlying pathophysiology.
Impact:
1. The occurrence of offspring biliary atresia may be related to maternal illness/drug use. 2. Maternal drug abuse and type 2 diabetes mellitus pose a high risk for offspring biliary atresia. 3. If maternal etiology is found, biliary atresia might be a preventable disease.
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