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Cholestatic Liver Disease and Pregnancy: A Systematic Review and Meta-Analysis
J Clin Med. 2022 Feb 18;11(4):1068. doi: 10.3390/jcm11041068.
Bryan Ferrigno1, Romelia Barba2, Esli Medina-Morales2, Hirsh Trivedi2, Vilas Patwardhan2, Alan Bonder2
Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA.
Division of Gastroenterology and Hepatology, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA.
Primary biliary cholangitis (PBC) and primary sclerosing cholangitis (PSC) are two types of chronic cholestatic liver disease (CCLD). Little is known regarding the relationship between these conditions and pregnancy. We performed a systematic review and meta-analysis regarding the maternal and fetal outcomes amongst patients with a known diagnosis of PBC and PSC undergoing pregnancy. Our analysis shows that patients with PBC and PSC who undergo pregnancy are at an increased risk of pre-term delivery, as well as the development of new or worsening pruritus during pregnancy. Additionally, patients with PBC are at higher risk of undergoing a biochemical disease flare during the postpartum period compared to during pregnancy. However, there were no documented cases of maternal mortality or development of decompensated cirrhosis during pregnancy or the postpartum period.