Autoimmune hepatitis during pregnancy: epidemiology, clinical manifestations, diagnosis, therapy, maternal and perinatal outcomes

Autoimmune hepatitis (AIH) is an evolving liver disease characterized by aminotransferase and IgG level increase in blood serum, presence of autoantibodies and histological features of hepatitis in the absence of known etiology. AIH is associated with an increased risk of preterm birth, hypertensive disorders, and gestational diabetes. This condition is also the cause of an increased cesarean section rate. In addition to adverse maternal outcomes cirrhosis negatively impacts the fetus, reducing live birth rates among patients with AIH. Data on the course of pregnancy with AIH are limited with few studies presented. Clinical guidelines for the management of AIH during pregnancy have not been developed, and there is an insufficient number of studies demonstrating pregnancy outcomes among patients with AIH. Apart from this, the incidence of AIH during pregnancy is increasing due to advanced diagnosis methods, pathogenetically based treatment, and prenatal and postnatal monitoring.

This study is aimed at the analysis of current data on the epidemiology, classification, diagnosis, treatment, and delivery methods in patients with AIH during pregnancy. We also present data on maternal and perinatal outcomes in pregnant women. Moreover, here we discuss modern approaches to pregnancy and postpartum care for AIH.

Conclusion: Timely diagnosis, adequate treatment and careful management of pregnancy in patients with AIH significantly reduce the risk of complications and improve both maternal and perinatal outcomes. Further study of the course of pregnancy in AIH, maternal and perinatal outcomes, as well as the influence of pregnancy on the course of the disease is paramount, since the data obtained may contribute to the development of preventive, diagnostic and therapeutic strategies.