Pregnancy outcomes in liver transplant patients, a population-based study.
J Matern Fetal Neonatal Med
; 30(3): 261-266, 2017 Feb.
Article
em En
| MEDLINE
| ID: mdl-27044922
ABSTRACT
OBJECTIVE:
To determine the incidence of pregnancy in liver transplant (LT) patients in a large population-based cohort and to determine the maternal and fetal risks associated with these pregnancies.METHODS:
We conducted an age-matched cohort study using the US Healthcare and Utilization project-Nationwide Inpatient Sample from 2003-2011. We used unconditional logistic regression, adjusted for baseline characteristics, to estimate the likelihood of common obstetric complications in the LT group compared with age-matched nontransplant patients.RESULTS:
There were 7 288 712 deliveries and an estimated incidence of 2.1 LTs/100 000 deliveries over the nine-year study period. LT patients had higher rates of maternal complications including hypertensive disorders (OR 6.5, 95% CI 4.4-9.5), gestational diabetes (OR 1.9, 95% CI 1.0-3.5), anemia (OR 3.2, 95% CI 2.1-4.9), thrombocytopenia (OR 27.5, 95% CI 12.7-59.8) and genitourinary tract infections (OR 4.2, 95% CI 1.8-9.8). Deliveries among women with LT had higher risks of cesarean section (OR 2.9, 95% CI 2.0-4.1), postpartum hemorrhage (OR 3.2, 95% CI 1.7-6.2) and blood transfusion (OR 18.7, 95% CI 8.5-41.0). Fetal complications in LT patients included preterm delivery (OR 4.7, 95% CI 3.2-7.0), intrauterine growth restriction (OR 4.1, 95% CI 2.1-7.7) and congenital anomalies (OR 6.0, 95% CI 1.1-32.0).CONCLUSION:
Although pregnancies in LT recipients are feasible, they are associated with a high rate of maternal and fetal morbidities. Close antenatal surveillance is recommended.Palavras-chave
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Complicações Pós-Operatórias
/
Complicações na Gravidez
/
Anormalidades Congênitas
/
Transplante de Fígado
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
/
Female
/
Humans
/
Newborn
/
Pregnancy
Idioma:
En
Ano de publicação:
2017
Tipo de documento:
Article