|
|
|
| Primary biliary cholangitis in pregnancy: A systematic review with meta-analysis |
| Hydar El Jamaly a , b , ∗, Guy D Eslick c , Martin Weltman a , b |
a Department of Gastroenterology and Hepatology, Nepean Hospital, Penrith, New South Wales, Australia
b Nepean Clinical School, The University of Sydney, Penrith, New South Wales, Australia
c NHMRC Centre for Research Excellence in Digestive Health, Hunter Medical Research Institute, The University of Newcastle, Newcastle, New South Wales, Australia
∗ Corresponding author at: Department of Gastroenterology and Hepatology, Nepean Hospital, Penrith, New South Wales, Australia
E-mail address: hydar.eljamaly@health.nsw.gov.au (H. El Jamaly). |
|
|
|
Abstract 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 < 0.001) with low level heterogeneity (I 2 < 0.001%). Patients had a statistically significant increased likelihood 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.
|
|
|
|
|
|
|
|
|
2022, Vol. 21 
