Good maternal and fetal outcomes for pregnant women with primary biliary cirrhosis

Palak J Trivedi, Teru Kumagi, Nadya Al-Harthy, Catalina Coltescu, Stephen Ward, Angela Cheung, Gideon M Hirschfield

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40 Citations (Scopus)


BACKGROUND & AIMS: Up to 25% of patients diagnosed with primary biliary cirrhosis (PBC) are of childbearing age. However, little is known about disease course during pregnancy.

METHODS: We performed a retrospective analysis of women with PBC during pregnancy using a representative large cohort of patients attending the Liver Center at Toronto Western hospital from January 1979 through June 2009 (n = 306). Statistical analysis was performed by using R statistical software.

RESULTS: We identified 32 women (50 pregnancies) who either became pregnant after a diagnosis of PBC or in whom pregnancy led to diagnosis. Liver biochemistry remained stable in most patients (70%) throughout pregnancy. However, 23 of 32 patients (72%) had a flare in biochemical disease activity post partum, which was unrelated to biochemical disease activity before conception (P = .53), or during the gestational period (P = .14). No adverse maternal events were observed during pregnancy or post partum, and only 2 of 32 of women (6%) developed progressive disease after delivery. De novo pruritus developed during pregnancy in 17 of 32 women (53%), whereas itch that existed before conception worsened for 4 patients. Fifteen of 21 women (71%) with pregnancy-related pruritus required symptom-specific therapy. Twenty-nine of 32 women (91%) had at least 1 successful live birth; adverse fetal outcome was not influenced by biochemical disease activity before conception (P = .24) or during pregnancy (P = 1.00).

CONCLUSION: Pregnancy in women with PBC is frequently symptomatic but mostly uneventful. The majority of women maintain stable liver biochemistry during pregnancy, although postpartum biochemical exacerbations are common.

Original languageEnglish
Pages (from-to)1179-1185.e1
JournalClinical Gastroenterology and Hepatology
Issue number7
Publication statusPublished - Jul 2014


  • Adult
  • Canada
  • Female
  • Humans
  • Liver Cirrhosis, Biliary
  • Pregnancy
  • Pregnancy Complications
  • Pregnancy Outcome
  • Retrospective Studies
  • Young Adult


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