Maternal and fetal outcomes of autoimmune hepatitis in pregnancy: A United States hospitalized patient study

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.