While pregnancy in liver transplant recipients is generally safe, the risk of complications for both mother and child is higher than for the general population, according to study results published in The American Journal of Gastroenterology.

Hepatitis B, hepatitis C, fatty liver disease, heavy alcohol use and other causes can lead to end-stage liver disease that requires a liver transplant. Such transplants are rising among women of reproductive age.

Nelson Valentin, MD, of the University of Pittsburgh School of Medicine, and colleagues carried out a systematic review and meta-analysis study to examine pregnancy outcomes after liver transplantation.

The team scanned the MEDLINE, Embase and Scopus databases to select studies on pregnancy outcomes among recipients of liver transplants. A total of 1,430 studies were found; of these, 38 were included in the analysis. Together they included 838 transplant recipients and 1,131 pregnancies.

The average age at the time of pregnancy was 27.8 years, and the average time interval between liver transplantation and pregnancy was 59.7 months. For these women, the live birth rate was 80%, and the average length of gestation was 36.5 weeks.

While the miscarriage rate (17%) was similar to that of the general population (between 10% and 20%), the rates of preterm birth (32%), preeclampsia (13%) and cesarean delivery (42%) were higher in women who had received a liver transplant compared with the general population (10%, 4% and 32%, respectively).

“Pregnancy outcomes after [liver transplantation] are favorable, but the risk of maternal and fetal complications is increased,” wrote the researchers. “Large studies along with consistent reporting to national registries are necessary for appropriate patient counseling and to guide clinical management of [liver transplant] recipients during pregnancy.”

Click here to read the study in The American Journal of Gastroenterology.