{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T03:23:04Z","timestamp":1784604184598,"version":"3.55.0"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2018,5,10]],"date-time":"2018-05-10T00:00:00Z","timestamp":1525910400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2018,5,10]],"date-time":"2018-05-10T00:00:00Z","timestamp":1525910400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Hepatology"],"published-print":{"date-parts":[[2018,8]]},"abstract":"<jats:p>Liver biopsy is an important procedure in the investigation of liver disease. We examined pregnancy outcomes in women who underwent liver biopsy during pregnancy. In a nationwide population\u2010based cohort study we linked data from the Swedish Medical Birth Registry (for births between 1992 and 2011) with those from the Swedish Patient Registry. We identified 23 pregnancies exposed to liver biopsy. We calculated relative risks (RRs) for adverse pregnancy outcomes according to liver biopsy status using 1,953,887 unexposed pregnancies with and without a record of liver disease as reference. Our main outcome measures were stillbirth and preterm birth. There were no stillbirths in pregnancies exposed to liver biopsies compared with 0.3% stillbirths in unexposed pregnancies, and 3\/23 (13%) exposed pregnancies were preterm (RR, 2.6; 95% confidence interval, 0.9\u20107.5). Compared to women with a record of liver disease, preterm birth was not increased in those exposed to liver biopsy (RR, 0.9; 95% confidence interval, 0.1\u20106.0). Except for an increased risk of small for gestational age birth in pregnancies exposed to liver biopsy (RR, 5.2; 95% confidence interval, 1.8\u201014.8), other adverse pregnancy outcomes were independent of liver biopsy status when the analysis was restricted to women with a diagnosis of liver disease. Compared with unexposed sibling pregnancies, pregnancies with a liver biopsy were 7 days shorter, but birth weights did not differ between the siblings (\u201367 g; <jats:italic toggle=\"yes\">P<\/jats:italic> &gt; 0.05). <jats:italic toggle=\"yes\">Conclusion<\/jats:italic>: Apart from a moderately increased risk of preterm birth and small for gestational age, there was no association between liver biopsy during pregnancy and adverse pregnancy outcome; potential excess risks should be weighed against the advantages of having a liver biopsy that may influence clinical management of the patient and indirectly fetal health. (H<jats:sc>epatology<\/jats:sc> 2017).<\/jats:p>","DOI":"10.1002\/hep.29345","type":"journal-article","created":{"date-parts":[[2017,6,27]],"date-time":"2017-06-27T12:12:48Z","timestamp":1498565568000},"page":"625-633","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":26,"title":["Pregnancy outcome in women undergoing liver biopsy during pregnancy: A nationwide population\u2010based cohort study"],"prefix":"10.1097","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1024-5602","authenticated-orcid":false,"given":"Jonas F.","family":"Ludvigsson","sequence":"first","affiliation":[{"name":"Department of Medical Epidemiology and Biostatistics,Karolinska Institutet,Stockholm,Sweden"},{"name":"Department of Pediatrics,\u00d6rebro University Hospital,\u00d6rebro,Sweden"},{"name":"Division of Epidemiology and Public Health, School of Medicine,University of Nottingham,City Hospital,Nottingham,UK"},{"name":"Department of Medicine,Columbia University College of Physicians and Surgeons,New York,NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanns\u2010Ulrich","family":"Marschall","sequence":"additional","affiliation":[{"name":"Sahlgrenska Academy, Institute of Medicine, Department of Molecular and Clinical Medicine,University of Gothenburg,Gothenburg,Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannes","family":"Hagstr\u00f6m","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology Unit, Department of Medicine Solna,Karolinska Institutet,Solna,Sweden"},{"name":"Center of Digestive Diseases, Division of Hepatology,Karolinska University Hospital,Stockholm,Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0012-1211","authenticated-orcid":false,"given":"Jonas","family":"H\u00f6ijer","sequence":"additional","affiliation":[{"name":"Unit of Biostatistics, Institute of Environmental Medicine,Karolinska Institutet,Stockholm,Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olof","family":"Stephansson","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology Unit, Department of Medicine Solna,Karolinska Institutet,Solna,Sweden"},{"name":"Department of Women's and Children's Health,Karolinska Institutet,Stockholm,Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2018,5,10]]},"reference":[{"key":"hep29345-bib-0001-20241017","first-page":"524","article-title":"Recent trends in hepatic diseases during pregnancy in the United States, 2002\u20102010","volume":"212","year":"2015","journal-title":"Am J Obstet Gynecol"},{"key":"hep29345-bib-0002-20241017","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1016\/j.cgh.2013.08.019","article-title":"Finding the needle in the haystack: predicting mortality in pregnancy\u2010related liver disease","volume":"12","year":"2014","journal-title":"Clin Gastroenterol Hepatol"},{"key":"hep29345-bib-0003-20241017","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1016\/j.cgh.2013.06.018","article-title":"Factors that predict 1\u2010month mortality in patients with pregnancy\u2010specific liver disease","volume":"12","year":"2014","journal-title":"Clin Gastroenterol Hepatol"},{"key":"hep29345-bib-0004-20241017","doi-asserted-by":"crossref","first-page":"1017","DOI":"10.1002\/hep.22742","article-title":"Liver biopsy","volume":"49","year":"2009","journal-title":"Hepatology"},{"key":"hep29345-bib-0005-20241017","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1038\/ajg.2015.430","article-title":"ACG Clinical guideline: liver disease and pregnancy","volume":"111","year":"2016","journal-title":"Am J Gastroenterol"},{"key":"hep29345-bib-0006-20241017","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1007\/BF01296222","article-title":"Does early diagnosis and delivery in acute fatty liver of pregnancy lead to improvement in maternal and infant survival?","volume":"29","year":"1984","journal-title":"Dig Dis Sci"},{"key":"hep29345-bib-0007-20241017","first-page":"314","article-title":"Diagnosis of early acute fatty liver of pregnancy","volume":"5","year":"1996","journal-title":"J Matern Fetal Med"},{"key":"hep29345-bib-0008-20241017","first-page":"806","article-title":"Acute fatty liver of pregnancy in triplet gestation","volume":"91","year":"1998","journal-title":"Obstet Gynecol"},{"key":"hep29345-bib-0009-20241017","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1097\/AOG.000000000000005","article-title":"Acute hepatic decompensation precipitated by pregnancy\u2010related catabolic stress: a rare mimic of acute liver failure","volume":"123","year":"2014","journal-title":"Obstet Gynecol"},{"key":"hep29345-bib-0010-20241017","doi-asserted-by":"crossref","first-page":"2324709614551558","DOI":"10.1177\/2324709614551558","article-title":"A spotty liver of pregnancy","volume":"2","year":"2014","journal-title":"J Investig Med High Impact Case Rep"},{"key":"hep29345-bib-0011-20241017","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1111\/hepr.12344","article-title":"Pregnant woman with non\u2010comatose autoimmune acute liver failure in the second trimester rescued using medical therapy: a case report","volume":"45","year":"2015","journal-title":"Hepatol Res"},{"key":"hep29345-bib-0012-20241017","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1016\/0002-9343(76)90374-0","article-title":"Jaundice in pregnancy\u20141976","volume":"61","year":"1976","journal-title":"Am J Med"},{"key":"hep29345-bib-0013-20241017","doi-asserted-by":"crossref","first-page":"1187","DOI":"10.1097\/01.AOG.0000160481.11517.a0","article-title":"Herpes simplex virus hepatitis causing acute liver dysfunction and thrombocytopenia in pregnancy","volume":"106","year":"2005","journal-title":"Obstet Gynecol"},{"key":"hep29345-bib-0014-20241017","first-page":"164","article-title":"Fatty liver in pregnancy. A report of two cases and medical literature review","volume":"74","year":"2006","journal-title":"[in Spanish] Ginecol Obstet Mex"},{"key":"hep29345-bib-0015-20241017","first-page":"540","article-title":"Acute fatty liver of pregnancy: diagnosis and management of 8 cases","volume":"113","year":"2000","journal-title":"Chin Med J (Engl)"},{"key":"hep29345-bib-0016-20241017","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1016\/S0002-9378(99)70567-3","article-title":"Reversible peripartum liver failure: a new perspective on the diagnosis, treatment, and cause of acute fatty liver of pregnancy, based on 28 consecutive cases","volume":"181","year":"1999","journal-title":"Am J Obstet Gynecol"},{"key":"hep29345-bib-0017-20241017","doi-asserted-by":"crossref","first-page":"450","DOI":"10.1186\/1471-2458-11-450","article-title":"External review and validation of the Swedish national inpatient register","volume":"11","year":"2011","journal-title":"BMC Public Health"},{"key":"hep29345-bib-0018-20241017","doi-asserted-by":"crossref","first-page":"843","DOI":"10.1111\/j.1651-2227.1996.tb14164.x","article-title":"Intrauterine growth curves based on ultrasonically estimated foetal weights","volume":"85","year":"1996","journal-title":"Acta Paediatr"},{"key":"hep29345-bib-0019-20241017","doi-asserted-by":"crossref","first-page":"554","DOI":"10.1053\/j.gastro.2016.10.016","article-title":"Outcomes of pregnancies for women undergoing endoscopy while they were pregnant: a nationwide cohort study","volume":"152","year":"2017","journal-title":"Gastroenterology"},{"key":"hep29345-bib-0020-20241017","first-page":"491","article-title":"Ethical aspects of registry\u2010based research in the Nordic countries","volume":"7","year":"2015","journal-title":"Clin Epidemiol"},{"key":"hep29345-bib-0021-20241017","doi-asserted-by":"crossref","first-page":"876","DOI":"10.1136\/gut.51.6.876","article-title":"Prospective study of liver dysfunction in pregnancy in southwest Wales","volume":"51","year":"2002","journal-title":"Gut"},{"key":"hep29345-bib-0022-20241017","doi-asserted-by":"crossref","first-page":"933","DOI":"10.1016\/j.jhep.2015.11.030","article-title":"Pregnancy and liver disease","volume":"64","year":"2016","journal-title":"J Hepatol"},{"key":"hep29345-bib-0023-20241017","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1111\/liv.12902","article-title":"Adverse outcomes of pregnancy in women with non\u2010alcoholic fatty liver disease","volume":"36","year":"2016","journal-title":"Liver Int"},{"key":"hep29345-bib-0024-20241017","doi-asserted-by":"crossref","first-page":"1163","DOI":"10.1111\/j.1478-3231.2011.02556.x","article-title":"Maternal hepatitis B and hepatitis C carrier status and perinatal outcomes","volume":"31","year":"2011","journal-title":"Liver Int"},{"key":"hep29345-bib-0025-20241017","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1111\/liv.12901","article-title":"Increased risk of preterm birth in women with autoimmune hepatitis\u2014a nationwide cohort study","volume":"36","year":"2016","journal-title":"Liver Int"},{"key":"hep29345-bib-0026-20241017","doi-asserted-by":"crossref","first-page":"506","DOI":"10.3109\/14767058.2015.1009438","article-title":"Outcomes of pregnancies complicated by liver cirrhosis, portal hypertension, or esophageal varices","volume":"29","year":"2016","journal-title":"J Matern Fetal Neonatal Med"}],"container-title":["Hepatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fhep.29345","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/01515467-201808000-00023","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,17]],"date-time":"2024-10-17T23:36:13Z","timestamp":1729208173000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/01515467-201808000-00023"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,5,10]]},"references-count":26,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2018]]}},"URL":"https:\/\/doi.org\/10.1002\/hep.29345","relation":{},"ISSN":["0270-9139","1527-3350"],"issn-type":[{"value":"0270-9139","type":"print"},{"value":"1527-3350","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,5,10]]},"assertion":[{"value":"2017-04-04","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-06-22","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}