Disclosures: The authors report no relevant financial disclosures.
February 22, 2021
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Pregnancy outcomes after liver transplantation are favorable

Disclosures: The authors report no relevant financial disclosures.
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Pregnancy after liver transplantation is feasible and safe but carries increased risk for some complications, according to study results.

Ilan Weisberg, MD, MSc, from the division of digestive diseases at Icahn School of Medicine at Mount Sinai, and colleagues wrote the number of pregnancies among liver transplantation (LT) recipients is expected to rise, but a lot is still unknown.

“The lack of randomized pharmacologic trials, heterogeneity among maternal and fetal outcome results, and knowledge deficits among providers challenge management of the intricacies of pregnancy after LT,” the wrote. “This meta-analysis aims to better define both maternal outcomes, particularly preeclampsia, cesarean section, and abortion, and fetal outcomes, namely preterm birth, abortion, and low birth weight in single liver transplant recipients globally.”

Investigators searched the literature for studies that explored pregnancy outcomes after LT. Researchers generated estimates for pregnancy-related outcomes among patients who underwent LT and pooled them across all studies.

Researchers included 38 studies comprising 1,131 pregnancies and 838 LT recipients in their analysis. The mean maternal age at pregnancy was 27.8 years and the mean interval from LT to pregnancy was 59.7 months.

The liver birth rate among mothers who underwent LT was 80.4%, while the mean gestational age was 36.5 weeks. The rate of miscarriages among LT recipients (16.7%) was similar to the rate among the general population (10%-20%).

However, compared with the general population, patients who underwent LT had higher rates of preterm births (9.9% vs. 32.1%), preeclampsia (4% vs. 12.5%) and cesarean delivery (32% vs. 42.2%).

“Consistent reporting regarding pregnancy outcomes among LT recipients is imperative to be able to provide comprehensive care and guidance in this population,” Weisberg and colleagues wrote. “Data on the effects of immunosuppression on pregnancy outcomes and their correlation to both maternal and fetal outcomes are lacking. Further studies evaluating this relationship are warranted.”