Pregnancy in autoimmune hepatitis: outcome and risk factors

Am J Gastroenterol. 2006 Mar;101(3):556-60. doi: 10.1111/j.1572-0241.2006.00479.x. Epub 2006 Feb 8.


Objective: Autoimmune hepatitis (AIH) may influence pregnancy outcome and pregnancy may affect AIH. We aimed at analyzing the disease course in pregnant AIH patients and at identifying disease-related risk factors for adverse pregnancy outcome.

Patients and methods: AIH patients with at least one pregnancy were identified at four liver units. The patients' records and the data obtained by detailed questionnaires were analyzed retrospectively. Forty-two pregnancies of 22 AIH patients were included.

Results: The rate of adverse pregnancy outcome was 26%; a medical explanation could be elucidated in only 4 of 11 pregnancies with adverse outcome. Of note, the 7 unexplained adverse pregnancy outcomes were highly associated with the presence of antibodies to SLA/LP (odds ratio 51; p < 0.003) and Ro/SSA (odds ratio 27; p < 0.02). Of 35 live births, 30 children developed normally over a mean observation period of nearly 5 yr. Eleven of these had been exposed to azathioprine in utero. The rate of serious maternal complications was 9% and a high rate (52%) of postpartum flares was noted.

Conclusions: The presence of autoantibodies may be a risk factor for adverse pregnancy outcome in AIH patients. Close monitoring of both mother and fetus seems advisable due to a significant rate of maternal and fetal complications.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Autoantibodies / blood
  • Biomarkers / blood*
  • Female
  • Hepatitis, Autoimmune / diagnosis*
  • Hepatitis, Autoimmune / epidemiology
  • Hepatitis, Autoimmune / immunology
  • Humans
  • Infant, Newborn
  • Liver Function Tests
  • Predictive Value of Tests
  • Pregnancy
  • Pregnancy Complications / diagnosis*
  • Pregnancy Complications / epidemiology
  • Pregnancy Complications / immunology
  • Pregnancy Outcome*
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • Stillbirth


  • Autoantibodies
  • Biomarkers