期刊
BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY
卷 129, 期 10, 页码 1644-1652出版社
WILEY
DOI: 10.1111/1471-0528.17156
关键词
-
Pregnancy and liver cirrhosis is a rare combination, but it is becoming more common. Liver cirrhosis increases the chances of maternal and fetal mortality and morbidity, although the exact risks are still unknown. A systematic literature review and meta-analysis were conducted to investigate maternal, fetal, and obstetric complications in pregnant women with liver cirrhosis. The results showed that pregnant women with liver cirrhosis have a higher risk of maternal mortality, variceal hemorrhage, preterm delivery, cesarean section, pre-eclampsia, and small-for-gestational-age neonates compared to the general obstetric population. Further large international prospective studies are needed to identify risk factors for unfavorable outcomes.
Background: Pregnancy and liver cirrhosis is a rare but increasing combination. Liver cirrhosis can raise the chance of maternal and fetal mortality and morbidity, although the exact risks remain unclear. Objective: To provide a systematic literature review and meta-analysis on maternal, fetal and obstetric complications among pregnant women with liver cirrhosis. Search strategy: We performed a systematic literature search in the databases PubMed/MEDLINE and EMBASE (Ovid) from inception through 25 January 2021. Selection criteria: Studies including pregnancies with liver cirrhosis and controls were eligible. Data collection and analysis: Two reviewers independently evaluated study eligibility. We used the random effects model for meta-analysis. Main results: Our search yielded 3118 unique papers. We included 11 studies, including 2912 pregnancies in women with cirrhosis from 1982--2020. Seven studies were eligible for inclusion in the meta-analysis. The overall maternal mortality rate was 0.89%. Maternal mortality and variceal haemorrhage were lower in recent than in older studies. Most cases of maternal mortality due to variceal haemorrhage (70%) occurred during vaginal delivery. Pregnant women with liver cirrhosis had a higher chance of preterm delivery (OR 6.7, 95% CI 5.1--9.1), caesarean section (OR 2.6, 95% CI 1.7-3.9), pre--eclampsia (OR 3.8, 95% CI 2.2- -6.5) and small-for-gestational-age neonates (OR 2.6, 95% CI 1.6- -4.2) compared with the general obstetric population. Subgroup analyses could not be conducted. Conclusions: Liver cirrhosis in pregnant women is associated with increases in maternal mortality and obstetric and fetal complications. Large international prospective studies are needed to identify risk factors for unfavourable outcome.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据