Outcomes of Pregnant Women With Cirrhosis and Their Infants in a Population-Based Study.

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The incidence of cirrhosis is increasing among women of childbearing age. Contemporary outcomes of pregnant women with cirrhosis and their infants, and liver-related complications, have not been described in North America. We investigated the association between cirrhosis and perinatal outcomes and evaluated perinatal liver-related events.We performed a retrospective cohort study using population-based administrative healthcare data from Ontario, Canada (2000-2017). We identified pregnant women with compensated cirrhosis (n=2022) using validated case definitions and routine mother-infant linkage; the women were matched to 10,110 pregnant women in the general population (1:5) based on birth year and socioeconomic status. Maternal and infant outcomes up to 6 weeks post-partum and liver-related complications up to 1 year post-partum were evaluated using multivariate log-binomial regression.After we adjusted for demographic and metabolic risk factors, cirrhosis was independently associated with intrahepatic cholestasis of pregnancy (relative risk [RR], 10.64, 95% CI, 7.49-15.12), induction of labor (RR, 1.15; 95% CI, 1.03-1.28), puerperal infections (RR, 1.32; 95% CI, 1.02-1.70), pre-term delivery (RR, 1.60; 95% CI, 1.35-1.89), infants that were large for gestational age (RR, 1.24; 95% CI, 1.05-1.46), and neonatal respiratory distress (RR, 1.20; 95% CI, 1.02-1.42). Fewer than 2% of pregnant women with cirrhosis had liver-related complications, but these occurred in a significantly higher proportion of women with a history of hepatic decompensation (13%) than women with compensated cirrhosis (1.2%) (P


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