Liver transplant linked to worse pregnancy-related complications
SAN ANTONIO — Pregnant women who were liver transplant recipients had more pregnancy-related complications and worse hospital outcomes during admission, according to data presented at the American College of Gastroenterology Meeting.
“As more women of childbearing age undergo transplantation and subsequently experience pregnancy, issues regarding complications and the effect on outcomes will only become more relevant,” Lindsay A. Sobotka, DO, a second-year fellow at The Ohio State University Wexner Medical Center, told Healio Gastroenterology and Liver Disease. “It is crucial to recognize factors that worsen patient and hospital outcomes in order to reduce patient morbidity and health care costs.”
Sobotka and colleagues analyzed a large, nationwide inpatient sample of data from 2005 to 2013 of pregnant women for the study.
Pregnant women who received a liver transplant were more likely than those who did not to have any pregnancy-related complications (56.1% vs. 27.1; P < .001), have a miscarriage (3.2% vs. 0.8%; P < .001), intrauterine growth restriction (5.6% vs. 2%; P < .001), postpartum hemorrhage (5.8% vs. 2.7%; P < .001), hypertension during pregnancy (35.1% vs. 9.5%; P < .001), preeclampsia (17.8% vs. 4.1%; P < .001), or venous thromboembolism (3.9% vs. 0.4%; P < .001).
Additionally, the liver transplant recipients were more likely to require a cesarean delivery than those who did not undergo transplantation (OR = 2.27; 9% CI, 1.62-3.18).
Weighted analysis confirmed that pregnant women who received a transplant were more likely to experience a pregnancy-related complication (OR = 2.11; 95% CI, 1.63-2.76), have a longer length of hospital stay (1.52 day; 95% CI, 0.62-2.41), and higher costs of admission ($3,023; 95% CI, 850-5,197).
However, the data did not show an increased risk for mortality during pregnancy for women who received a transplant.
“These results continue to highlight that liver transplant patients can experience pregnancy without a significant risk for mortality,” Sobotka said. “While there has previously been concerns about transplant patients experiencing pregnancy given fear of complications and outcomes, we continue to provide evidence that pregnancy should not be advised against in this patient population.” – by Talitha Bennett
Sobotka LA, et al. Abstract 13. Presented at: American College of Gastroenterology Annual Meeting; Oct. 25-30, 2019; San Antonio.
Disclosures: Sobotka reports no relevant financial disclosures.