{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T10:49:32Z","timestamp":1792838972950,"version":"4.5.0"},"reference-count":34,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,3,13]],"date-time":"2025-03-13T00:00:00Z","timestamp":1741824000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Describe maternal\/fetal outcomes of pregnant women with cirrhosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Prospective, national cohort study utilising the UK Obstetric Surveillance System between 1st June 2017 and 30th November 2020.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>UK.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>Pregnant women with cirrhosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Rates of adverse perinatal outcomes were compared with published rates for uncomplicated pregnancies. The prediction of adverse pregnancy outcomes by albumin\u2010bilirubin (ALBI) score was determined.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Outcome Measures<\/jats:title><jats:p>Maternal and fetal outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>52 eligible cases were reported (denominators represent available data for each outcome). Commonest causes included autoimmune hepatitis (12\/50 (24.0%)), cholestatic disease (9\/50 (18.0%)) and viral disorders (8\/50 (18.0%)). Maternal decompensation occurred in seven women. Worst ALBI score predicted decompensation and maternal ICU admission (AUROC 0.80 (<jats:italic>p<\/jats:italic>\u2009=\u20090.03) and 0.81 (<jats:italic>p<\/jats:italic>\u2009=\u20090.03), respectively). Untreated varices were associated with increased rates of variceal bleed (<jats:italic>p<\/jats:italic>\u2009=\u20090.01). No women died. There were 42 live births (51.2% preterm), one stillbirth, and two neonatal deaths. The worst ALBI score in pregnancy predicted pre\u2010term birth (AUROC 0.74 (<jats:italic>p<\/jats:italic>\u2009=\u20090.03)). Compared to a healthy population, women with cirrhosis were at increased risk of cholestasis in pregnancy (OR 29.4, 95% CI 13.8\u201361.6, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), ICU admission (OR 42.5,95% CI 15.2\u2013118.8, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), pre\u2010term birth (OR 13.2, 95% CI 7.1\u201324.4, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), and babies with low birth weight (OR 12.0, 95% CI 6.5\u201322.0, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), neonatal intensive care unit admission (OR 4.4, 95% CI 2.4\u20138.2, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and perinatal mortality (OR 15.8, 95% CI 4.9\u201351.3, p\u2009&lt;\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Women with cirrhosis and their babies are at increased risk during pregnancy. The ALBI score predicts maternal decompensation, ICU admission, and pre\u2010term birth.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.18107","type":"journal-article","created":{"date-parts":[[2025,3,14]],"date-time":"2025-03-14T05:03:57Z","timestamp":1741928637000},"page":"935-943","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Pregnancy Outcomes in Women With Liver Cirrhosis: A National Prospective Cohort Study Using the <scp>UK<\/scp> Obstetric Surveillance System"],"prefix":"10.1111","volume":"132","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7908-8986","authenticated-orcid":false,"given":"Melanie","family":"Nana","sequence":"first","affiliation":[{"name":"Department of Women and Children's Health King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agata","family":"Majewska","sequence":"additional","affiliation":[{"name":"Department of Women and Children's Health King's College London  London UK"},{"name":"Department of Obstetrics and Gynaecology Institute of Mother and Child  Warsaw Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mussarat","family":"Rahim","sequence":"additional","affiliation":[{"name":"Department of Hepatology King\u2018s College Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria","family":"Geenes","sequence":"additional","affiliation":[{"name":"Department of Women and Children's Health King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4859-0324","authenticated-orcid":false,"given":"Caroline","family":"Ovadia","sequence":"additional","affiliation":[{"name":"Department of Women and Children's Health King's College London  London 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