{
    "abstract": "While some articles describe outcome of pregnancy in autoimmune hepatitis (AIH), there are less data evaluating influence of AIH control on maternal and perinatal outcomes. This study analysed outcomes of pregnancy and related possible risk factors in AIH.\nA retrospective multicentre cohort study on pregnancy in AIH was performed in 11 hospitals in the Netherlands. Maternal and neonatal outcomes were collected from records and completed by interview. Risk factors-including incomplete response, relapse and cirrhosis-for adverse outcomes were identified using logistic regression analysis.\nNinety-seven pregnancies in 50 women resulted in 70 deliveries (72%) with a live birth rate of 98.5%. AIH relapse occurred in 6% during pregnancy, and in 27% of post-partum episodes. Absence of complete biochemical response at conception was identified as risk factor for the occurrence of gestational and post-partum relapses. Relapse of AIH in the year before conception was a risk factor for the occurrence of both gestational relapses and post-partum relapses. No complete biochemical response increased the risk for hypertensive disorders during pregnancy and intrahepatic cholestasis of pregnancy (ICP). Cirrhosis was found to be a risk factor for miscarriages, but not for other outcomes.\nPregnancy in AIH is related to an increased incidence of maternal and fetal/neonatal complications; in most cases, outcome is good. Incomplete biochemical response at conception or relapse in the year before conception are risk factors for gestational and post-partum relapses, for hypertensive disorders and for ICP. Cirrhosis was a risk factor for miscarriages.",
    "authors": [
        {
            "affiliation": "Department of Gastroenterology and Hepatology, Leiden University Medical Centre, Leiden, the Netherlands.",
            "firstname": "Susan E",
            "initials": "SE",
            "lastname": "Fischer"
        },
        {
            "affiliation": "Department of Gastroenterology and Hepatology, Leiden University Medical Centre, Leiden, the Netherlands.",
            "firstname": "Elsemieke S",
            "initials": "ES",
            "lastname": "de Vries"
        },
        {
            "affiliation": "Department of Gastroenterology and Hepatology, Leiden University Medical Centre, Leiden, the Netherlands.",
            "firstname": "Maarten E",
            "initials": "ME",
            "lastname": "Tushuizen"
        },
        {
            "affiliation": "Department of Gastroenterology and Hepatology, Amsterdam University Medical Centre, Amsterdam, the Netherlands.",
            "firstname": "Ynto S",
            "initials": "YS",
            "lastname": "de Boer"
        },
        {
            "affiliation": "Department of Gastroenterology and Hepatology, Erasmus Medical Centre, Rotterdam, the Netherlands.",
            "firstname": "Adriaan J P",
            "initials": "AJP",
            "lastname": "van der Meer"
        },
        {
            "affiliation": "Department of Gastroenterology and Hepatology, Erasmus Medical Centre, Rotterdam, the Netherlands.",
            "firstname": "Robert A",
            "initials": "RA",
            "lastname": "de Man"
        },
        {
            "affiliation": "Department of Gastroenterology and Hepatology, Reinier de Graaf Gasthuis, Delft, the Netherlands.",
            "firstname": "Johannes T",
            "initials": "JT",
            "lastname": "Brouwer"
        },
        {
            "affiliation": "Department of Gastroenterology and Hepatology, Spaarne Gasthuis, Hoofddorp, the Netherlands.",
            "firstname": "Johan P",
            "initials": "JP",
            "lastname": "Kuyvenhoven"
        },
        {
            "affiliation": "Department of Gastroenterology and Hepatology, Noordwest Ziekenhuisgroep, Alkmaar, the Netherlands.",
            "firstname": "Michael",
            "initials": "M",
            "lastname": "Klemt-Kropp"
        },
        {
            "affiliation": "Department of Gastroenterology and Hepatology, Maastricht University Medical Centre, Maastricht, the Netherlands.",
            "firstname": "Tom J G",
            "initials": "TJG",
            "lastname": "Gevers"
        },
        {
            "affiliation": "Department of Gastroenterology and Hepatology, Radboud University Medical Centre, Nijmegen, the Netherlands.",
            "firstname": "Eric T T L",
            "initials": "ETTL",
            "lastname": "Tjwa"
        },
        {
            "affiliation": "Department of Gastroenterology and Hepatology, Maasstad Hospital, Rotterdam, the Netherlands.",
            "firstname": "Edith M M",
            "initials": "EMM",
            "lastname": "Kuiper"
        },
        {
            "affiliation": "Department of Gastroenterology and Hepatology, Diakonessenhuis, Utrecht, the Netherlands.",
            "firstname": "Marc A M T",
            "initials": "MAMT",
            "lastname": "Verhagen"
        },
        {
            "affiliation": "Department of Gastroenterology and Hepatology, Meander Medical Centre, Amersfoort, the Netherlands.",
            "firstname": "Philip W",
            "initials": "PW",
            "lastname": "Friederich"
        },
        {
            "affiliation": "Department of Gastroenterology and Hepatology, Leiden University Medical Centre, Leiden, the Netherlands.",
            "firstname": "Bart",
            "initials": "B",
            "lastname": "van Hoek"
        }
    ],
    "conclusions": "Pregnancy in AIH is related to an increased incidence of maternal and fetal/neonatal complications; in most cases, outcome is good. Incomplete biochemical response at conception or relapse in the year before conception are risk factors for gestational and post-partum relapses, for hypertensive disorders and for ICP. Cirrhosis was a risk factor for miscarriages.",
    "copyrights": "\u00a9 2023 The Authors. Liver International published by John Wiley & Sons Ltd.",
    "doi": "10.1111/liv.15511",
    "journal": "Liver international : official journal of the International Association for the Study of the Liver",
    "keywords": [
        "autoimmune hepatitis",
        "outcome",
        "pregnancy",
        "remission"
    ],
    "methods": "A retrospective multicentre cohort study on pregnancy in AIH was performed in 11 hospitals in the Netherlands. Maternal and neonatal outcomes were collected from records and completed by interview. Risk factors-including incomplete response, relapse and cirrhosis-for adverse outcomes were identified using logistic regression analysis.",
    "publication_date": "2023-01-04",
    "pubmed_id": "36594353",
    "results": "Ninety-seven pregnancies in 50 women resulted in 70 deliveries (72%) with a live birth rate of 98.5%. AIH relapse occurred in 6% during pregnancy, and in 27% of post-partum episodes. Absence of complete biochemical response at conception was identified as risk factor for the occurrence of gestational and post-partum relapses. Relapse of AIH in the year before conception was a risk factor for the occurrence of both gestational relapses and post-partum relapses. No complete biochemical response increased the risk for hypertensive disorders during pregnancy and intrahepatic cholestasis of pregnancy (ICP). Cirrhosis was found to be a risk factor for miscarriages, but not for other outcomes.",
    "title": "Importance of complete response for outcomes of pregnancy in patients with autoimmune hepatitis.",
    "xml": "<Element 'PubmedArticle' at 0x788506b4b150>"
}