Original article—liver, pancreas, and biliary tractImpact of Cirrhosis and Liver Transplant on Maternal Health During Labor and Delivery
Section snippets
Data Source
All data were extracted from the Nationwide Inpatient Sample (NIS) between the years 1998 and 2005. The NIS database contains discharge abstracts from more than 1000 academic and community hospitals in the United States, reflecting a 20% stratified sample of all nonfederal acute care hospitals. The database is maintained as part of the Healthcare Cost and Utilization Project, sponsored by the Agency for Healthcare Research and Quality. NIS data concur with the National Hospital Discharge
Results
In the NIS database, there were 187 infant deliveries among cirrhotic women and 86 infant deliveries among women with transplanted livers, corresponding to 930 and 419 total deliveries, respectively, in these groups of patients throughout the United States between 1998 and 2005. There also were 662,408 infant deliveries among the 10% sample of women without liver disease. There were no significant time trends in the number of admissions for either cirrhosis or prior liver transplant over the
Discussion
In this nationwide analysis of obstetrical patients, we have been able to show that women with a history of cirrhosis or liver transplant at the time of pregnancy have an increased rate of serious health complications and longer LOHS during labor and delivery than women without any known liver disease. Cirrhotic women had a greater overall risk of adverse health outcomes than women who had undergone prior liver transplant; moreover, several of the complications observed in women with prior
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Conflicts of interest The authors disclose no conflicts.
Funding This work was supported by an AGA Research Scholar Award by the Foundation for Digestive Health and Nutrition (G.C.N.). The sponsor had no role in the study design, collection, analysis, or interpretation of data.