Data on pregnancy outcomes in women with cirrhosis is scarce. Thus a study examined the records of singleton births from Sweden’s National Patient Register (NPR), Cause of Death Register (CDR), and Medical Birth Register (MBR) to estimate exposure and pregnancy-related and liver-related outcomes of pregnant women with cirrhosis. 

Exposure status was described as containing an International Classification of Diseases (ICD) code for cirrhosis acquired prior to or during pregnancy. Relative risks (RRs) adjusted for maternal age, smoking, and body mass index (BMI) were estimated. 

103 pregnancies in women with cirrhosis were identified and compared with 1,361,566 pregnancies in women without cirrhosis. 

The following observations were made-

• Pregnancies in women with cirrhosis had an increased risk of caesarean delivery (36% versus 16%), low birth weight (15% versus 3%), and preterm delivery (19% versus 5%). 
• Rates of maternal mortality during pregnancy (no cases), gestational diabetes, preeclampsia, small for gestational age, congenital malformations, and stillbirth were similar to the pregnant women without cirrhosis. 
• 12 hospitalizations during pregnancy due to liver-related events were noted, involving one case with bleeding esophageal varices. 

Thus, women with cirrhosis possess an increased risk for adverse pregnancy outcomes. However, severe maternal and fetal adverse events are rare as per this study, and most pregnancies in women with cirrhosis were completed without complications.

SOURCE- Outcomes of Pregnancy in Mothers With Cirrhosis: A National Population-Based Cohort Study of 1.3 Million Pregnancies, 2018;2(11): 1299-1305.  https://doi.org/10.1002/hep4.1255