Maternal and fetal outcomes of autoimmune hepatitis in pregnancy: A United States hospitalized patient study - 01/02/25

Doi : 10.1016/j.clinre.2025.102544

Xi Li ^a, Jing Zhang ^b, Sheza Malik ^c, Aakriti Jain ^c, Mingyuan Wang ^a,^⁎ , Chengu Niu ^c,^⁎
^a Department of General Surgery, Xiangya Hospital, Central South University, 410008 Changsha, Hunan, China
^b Rainier Springs Behavioral Health Hospital, 2805 NE 129th St, Vancouver, WA 98686, USA
^c Internal medicine residency program, Rochester General Hospital, Rochester, NY 14621, USA.

^⁎Corresponding author: Chengu Niu, 1425 Portland Avenue, Rochester, Internal medicine residency program, Rochester General Hospital, Rochester, NY 14621, USA, Phone: (585) 922-4365; Fax: (585) 922-4440, Internal medicine residency programRochester General Hospital1425 Portland Avenue, RochesterRochesterNY14621USA^⁎⁎Corresponding author: Mingyuan Wang, No. 87, Xiangya Road, Kaifu District, Department of General Surgery, Xiangya Hospital, Central South University, Changsha, Hunan 410008, ChinaDepartment of General SurgeryXiangya HospitalCentral South UniversityNo. 87, Xiangya Road, Kaifu DistrictChangshaHunan410008China

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Research highlights

•	Study shows rising AIH incidence among pregnant patients from 2016 to 2020.
•	AIH linked to increased risks of hypertensive disorders, preterm birth, fetal restriction and fetal death.
•	AIH associated with higher hospital costs and longer stays during delivery.

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Abstract

Background

Autoimmune hepatitis (AIH) is a chronic inflammatory disease primarily affecting the liver, with a higher prevalence among women of reproductive age. The latest nationwide statistics regarding its impact on maternal and fetal outcomes during pregnancy are lacking.

Aims

To analyze the real impact of AIH on maternal and fetal outcomes in hospitalized delivery patients, and provide theoretical guidance for comprehensive clinical management.

Methods

A retrospective analysis was conducted using data from the 2016-2020 National Inpatient Sample database in the United States. Multivariate logistic regression analysis was used to assess the influence of AIH on maternal and fetal outcomes during pregnancy.

Results

A total of 17,825,445 hospitalized delivery patients were included, among which 1,185 had AIH. After adjusting for potential confounding factors, compared to hospitalized delivery patients without AIH, the AIH group exhibited significantly higher rates of adverse maternal and fetal outcomes, including hypertension complications of pregnancy (AOR 1.68, 95% CI 1.09-2.58), preterm birth (AOR 2.89, 95% CI 1.91-4.38), fetal growth restriction (AOR 2.21, 95% CI 1.34-3.64), and fetal death (AOR 4.13, 95% CI 1.33-12.83). AIH showed no association with cesarean section or large fetus. In the group of delivery in patients with AIH, patients who develop hypertensive disorders have a higher probability of concomitant diabetes mellitus (OR 6.85, 95% CI 2.19–21.45), hypertension (OR 4.64, 95% CI 1.68–12.82), and obesity (OR 3.06, 95% CI 1.26–7.42). Additionally, AIH patients incurred higher total costs and longer hospital stays during the delivery hospitalization.

Conclusion

Patients with AIH face an increased risk of hypertensive disorders of pregnancy, preterm birth, fetal growth restriction, and fetal death during delivery. It is crucial to enhance awareness of these potential occurrence risks.

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KEYWORDS : Autoimmune hepatitis, national inpatient sample, preeclampsia, pregnancy, preterm birth