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Pregnancy Outcome in Women Undergoing Liver Biopsy During Pregnancy: A Nationwide Population-Based Cohort Study
Örebro University, School of Medical Sciences. Örebro University Hospital. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Pediatrics, Örebro University Hospital, Örebro, Sweden; Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, UK; Department of Medicine, Columbia University College of Physicians and Surgeons, New York, USA.ORCID iD: 0000-0003-1024-5602
Sahlgrenska Academy, Institute of Medicine, Department of Molecular and Clinical Medicine, University of Gothenburg, Gothenburg, Sweden.
Clinical Epidemiology Unit, Department of Medicine, Karolinska Institutet, Solna, Sweden; Center of Digestive Diseases, Division of Hepatology, Karolinska University Hospital, Stockholm, Sweden.
Unit of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Sweden.
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2017 (English)In: Hepatology, ISSN 0270-9139, E-ISSN 1527-3350Article in journal (Refereed) Epub ahead of print
Abstract [en]

Liver biopsy is an important procedure in the investigation of liver disease. We examined pregnancy outcomes in women who underwent liver biopsy during pregnancy. In a nationwide population-based cohort study we linked data from the Swedish Medical Birth Registry (for births between 1992 and 2011) with those from the Swedish Patient Registry. We identified 23 pregnancies exposed to liver biopsy. We calculated relative risks (RRs) for adverse pregnancy outcomes according to liver biopsy status using 1,953,887 unexposed pregnancies with and without a record of liver disease as reference. Our main outcome measures were stillbirth and preterm birth. There were no stillbirths in pregnancies exposed to liver biopsies compared with 0.3% stillbirths in unexposed pregnancies. 3/23 (13%) exposed pregnancies were preterm (RR=2.6; 95%CI=0.9-7.5). Compared with women with a record of liver disease, preterm birth was not increased in those exposed to liver biopsy (RR=0.9; 95%CI=0.1-6.0). Except for an increased risk of small for gestational age birth in pregnancies exposed to liver biopsy (RR=5.2; 95%CI=1.8-14.8), other adverse pregnancy outcomes were independent of liver biopsy status when the analysis was restricted to women with a diagnosis of liver disease. Compared with unexposed sibling pregnancies, pregnancies with a liver biopsy were 7 days shorter, but birth weights did not differ between the siblings (-67g; p>0.05).

CONCLUSION: Apart from a moderately increased risk of preterm birth and small for gestational age, there was no association between liver biopsy during pregnancy and adverse pregnancy outcome. Potential excess risks should be weighed against the advantages of having a liver biopsy that may influence clinical management of the patient indirectly influencing fetal health.

Place, publisher, year, edition, pages
John Wiley & Sons, 2017.
Keyword [en]
birth, fetal, fetus, gastroenterology, liver disease
National Category
Gastroenterology and Hepatology
Identifiers
URN: urn:nbn:se:oru:diva-61163DOI: 10.1002/hep.29345PubMedID: 28653764OAI: oai:DiVA.org:oru-61163DiVA: diva2:1144803
Available from: 2017-09-27 Created: 2017-09-27 Last updated: 2017-10-02Bibliographically approved

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Ludvigsson, Jonas F.
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