Outcomes of pregnancies complicated by cirrhosis: a retrospective cohort study
Abstract Background Although pregnancy complicated by liver cirrhosis is rare, women with cirrhosis experience increased adverse pregnancy outcomes. This study aimed to evaluate pregnancy outcomes in women with liver cirrhosis and develop a predictive model using maternal factors for preterm birth i...
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| Format: | Article |
| Language: | English |
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BMC
2024-03-01
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| Series: | BMC Pregnancy and Childbirth |
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| Online Access: | https://doi.org/10.1186/s12884-024-06341-1 |
| _version_ | 1797266591386173440 |
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| author | Zhangmin Tan Peizhen Zhang Jin Zhou Chuo Li Chengfang Xu Yuzhu Yin |
| author_facet | Zhangmin Tan Peizhen Zhang Jin Zhou Chuo Li Chengfang Xu Yuzhu Yin |
| author_sort | Zhangmin Tan |
| collection | DOAJ |
| description | Abstract Background Although pregnancy complicated by liver cirrhosis is rare, women with cirrhosis experience increased adverse pregnancy outcomes. This study aimed to evaluate pregnancy outcomes in women with liver cirrhosis and develop a predictive model using maternal factors for preterm birth in such pregnancies. Methods A retrospective analysis was conducted on pregnancy outcomes of a cirrhosis group (n = 43) and a non-cirrhosis group (n = 172) in a university hospital between 2010 and 2022. Logistic regression evaluated pregnancy outcomes, and a forward stepwise logistic regression model was designed to predict preterm birth in pregnant women with cirrhosis. The model's predictive performance was evaluated using the receiver operating characteristic (ROC) curve and the area under the ROC curve (AUC). Results The incidence of cirrhosis during pregnancy was 0.06% (50/81,554). Pregnant women with cirrhosis faced increased risks of cesarean section, preterm birth, intrahepatic cholestasis of pregnancy, thrombocytopenia, and postpartum hemorrhage. In pregnant women with cirrhosis, preterm birth risk significantly increased at an incidence rate of 46.51% (20/43). According to the prediction model, the key predictors of preterm birth in pregnant women with cirrhosis were intrahepatic cholestasis of pregnancy and total bilirubin. The model demonstrated accurate prediction, with an AUC of 0.847, yielding a model accuracy of 81.4%. Conclusions Pregnant women with cirrhosis face a heightened risk of adverse obstetric outcomes, particularly an increased incidence of preterm birth. The preliminary evidence shows that the regression model established in our study can use the identified key predictors to predict preterm birth in pregnant women with cirrhosis, with high accuracy. |
| first_indexed | 2024-04-25T01:03:07Z |
| format | Article |
| id | doaj.art-c99907aa2ffe46d7890c194f294c4076 |
| institution | Directory Open Access Journal |
| issn | 1471-2393 |
| language | English |
| last_indexed | 2024-04-25T01:03:07Z |
| publishDate | 2024-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj.art-c99907aa2ffe46d7890c194f294c40762024-03-10T12:24:08ZengBMCBMC Pregnancy and Childbirth1471-23932024-03-012411910.1186/s12884-024-06341-1Outcomes of pregnancies complicated by cirrhosis: a retrospective cohort studyZhangmin Tan0Peizhen Zhang1Jin Zhou2Chuo Li3Chengfang Xu4Yuzhu Yin5Departments of Obstetrics and Gynecology, The Third Affiliated Hospital of Sun Yat-Sen UniversityDepartments of Obstetrics and Gynecology, The Third Affiliated Hospital of Sun Yat-Sen UniversityDepartments of Obstetrics and Gynecology, The Third Affiliated Hospital of Sun Yat-Sen UniversityDepartments of Obstetrics and Gynecology, The Third Affiliated Hospital of Sun Yat-Sen UniversityDepartments of Obstetrics and Gynecology, The Third Affiliated Hospital of Sun Yat-Sen UniversityDepartments of Obstetrics and Gynecology, The Third Affiliated Hospital of Sun Yat-Sen UniversityAbstract Background Although pregnancy complicated by liver cirrhosis is rare, women with cirrhosis experience increased adverse pregnancy outcomes. This study aimed to evaluate pregnancy outcomes in women with liver cirrhosis and develop a predictive model using maternal factors for preterm birth in such pregnancies. Methods A retrospective analysis was conducted on pregnancy outcomes of a cirrhosis group (n = 43) and a non-cirrhosis group (n = 172) in a university hospital between 2010 and 2022. Logistic regression evaluated pregnancy outcomes, and a forward stepwise logistic regression model was designed to predict preterm birth in pregnant women with cirrhosis. The model's predictive performance was evaluated using the receiver operating characteristic (ROC) curve and the area under the ROC curve (AUC). Results The incidence of cirrhosis during pregnancy was 0.06% (50/81,554). Pregnant women with cirrhosis faced increased risks of cesarean section, preterm birth, intrahepatic cholestasis of pregnancy, thrombocytopenia, and postpartum hemorrhage. In pregnant women with cirrhosis, preterm birth risk significantly increased at an incidence rate of 46.51% (20/43). According to the prediction model, the key predictors of preterm birth in pregnant women with cirrhosis were intrahepatic cholestasis of pregnancy and total bilirubin. The model demonstrated accurate prediction, with an AUC of 0.847, yielding a model accuracy of 81.4%. Conclusions Pregnant women with cirrhosis face a heightened risk of adverse obstetric outcomes, particularly an increased incidence of preterm birth. The preliminary evidence shows that the regression model established in our study can use the identified key predictors to predict preterm birth in pregnant women with cirrhosis, with high accuracy.https://doi.org/10.1186/s12884-024-06341-1Liver cirrhosisLogistic modelsObstetric outcomePregnancyPreterm birthPrognosis |
| spellingShingle | Zhangmin Tan Peizhen Zhang Jin Zhou Chuo Li Chengfang Xu Yuzhu Yin Outcomes of pregnancies complicated by cirrhosis: a retrospective cohort study BMC Pregnancy and Childbirth Liver cirrhosis Logistic models Obstetric outcome Pregnancy Preterm birth Prognosis |
| title | Outcomes of pregnancies complicated by cirrhosis: a retrospective cohort study |
| title_full | Outcomes of pregnancies complicated by cirrhosis: a retrospective cohort study |
| title_fullStr | Outcomes of pregnancies complicated by cirrhosis: a retrospective cohort study |
| title_full_unstemmed | Outcomes of pregnancies complicated by cirrhosis: a retrospective cohort study |
| title_short | Outcomes of pregnancies complicated by cirrhosis: a retrospective cohort study |
| title_sort | outcomes of pregnancies complicated by cirrhosis a retrospective cohort study |
| topic | Liver cirrhosis Logistic models Obstetric outcome Pregnancy Preterm birth Prognosis |
| url | https://doi.org/10.1186/s12884-024-06341-1 |
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