Evidence map›Paper›PMID 40083076›Full record

ArticleBJOG : an international journal of obstetrics and gynaecology2025

Pregnancy Outcomes in Women With Liver Cirrhosis: A National Prospective Cohort Study Using the UK Obstetric Surveillance System.

Melanie Nana, Agata Majewska, Mussarat Rahim, Victoria Geenes, Caroline Ovadia, Marian Knight, Michael Heneghan, Catherine Williamson

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Article in BJOG : an international journal of obstetrics and gynaecology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

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4citing papers in PubMed
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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Melanie NanaDepartment of Women and Children's Health, King's College London, London, UK.ORCID https://orcid.org/0000-0002-7908-8986
Agata MajewskaDepartment of Women and Children's Health, King's College London, London, UK.
Mussarat RahimDepartment of Hepatology, King's College Hospital, London, UK.
Victoria GeenesDepartment of Women and Children's Health, King's College London, London, UK.
Caroline OvadiaDepartment of Women and Children's Health, King's College London, London, UK.ORCID https://orcid.org/0000-0002-4859-0324
Marian KnightNational Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.ORCID https://orcid.org/0000-0002-1984-4575
Michael HeneghanDepartment of Hepatology, King's College Hospital, London, UK.
Catherine WilliamsonDepartment of Women and Children's Health, King's College London, London, UK.

Funding

Lauren Page Trust
6 · The paper itself

Abstract

objectiveDescribe maternal/fetal outcomes of pregnant women with cirrhosis.

designProspective, national cohort study utilising the UK Obstetric Surveillance System between 1st June 2017 and 30th November 2020.

settingUK. POPULATION: Pregnant women with cirrhosis.

methodsRates of adverse perinatal outcomes were compared with published rates for uncomplicated pregnancies. The prediction of adverse pregnancy outcomes by albumin-bilirubin (ALBI) score was determined.

main outcome measuresMaternal and fetal outcomes.

results52 eligible cases were reported (denominators represent available data for each outcome). Commonest causes included autoimmune hepatitis (12/50 (24.0%)), cholestatic disease (9/50 (18.0%)) and viral disorders (8/50 (18.0%)). Maternal decompensation occurred in seven women. Worst ALBI score predicted decompensation and maternal ICU admission (AUROC 0.80 (p = 0.03) and 0.81 (p = 0.03), respectively). Untreated varices were associated with increased rates of variceal bleed (p = 0.01). No women died. There were 42 live births (51.2% preterm), one stillbirth, and two neonatal deaths. The worst ALBI score in pregnancy predicted pre-term birth (AUROC 0.74 (p = 0.03)). Compared to a healthy population, women with cirrhosis were at increased risk of cholestasis in pregnancy (OR 29.4, 95% CI 13.8-61.6, p < 0.001), ICU admission (OR 42.5,95% CI 15.2-118.8, p < 0.001), pre-term birth (OR 13.2, 95% CI 7.1-24.4, p < 0.001), and babies with low birth weight (OR 12.0, 95% CI 6.5-22.0, p < 0.001), neonatal intensive care unit admission (OR 4.4, 95% CI 2.4-8.2, p < 0.001) and perinatal mortality (OR 15.8, 95% CI 4.9-51.3, p < 0.001).

conclusionWomen with cirrhosis and their babies are at increased risk during pregnancy. The ALBI score predicts maternal decompensation, ICU admission, and pre-term birth.

Indexed as

Liver CirrhosisPregnancy ComplicationsPregnancy OutcomeAdultFemaleHumansInfant, NewbornPregnancyProspective StudiesUnited KingdomALBI scorecirrhosisliver diseasemorbiditymortalityneonatalperinatal

Identifiers

PMID40083076
PMCPMC12051225

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