Liver Diseases in the Perinatal Period: Interactions Between Mother and Infant

Ibrahim, Samar H.; Jonas, Maureen M.; Taylor, Sarah; Sanchez, Luz Helena Gutierrez; Wolf, Jaqueline L.; Sundaram, Shikha S.

doi:10.1002/hep.31109

Cited by 18 publications

(22 citation statements)

References 55 publications

(133 reference statements)

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“…(215)(216)(217) Proposed underlying mechanisms include epigenetic reprograming, mitochondrial dysfunction, dysbiosis, and immune dysregulation with a more proinflammatory state. (218) Breastfeeding and duration of lactation have been associated with a lower incidence of future metabolic complications, including NAFLD, presumably related to postpartum weight loss and return of blood glucose, lipid, and insulin concentrations to pre-pregnancy levels. (219,220) Breastfeeding may have a protective effect on development and severity of NAFLD in children.…”

Section: Nonalcoholic Fatty Liver Diseasementioning

confidence: 99%

Reproductive Health and Liver Disease: Practice Guidance by the American Association for the Study of Liver Diseases

et al. 2021

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Section: Nonalcoholic Fatty Liver Diseasementioning

confidence: 99%

Reproductive Health and Liver Disease: Practice Guidance by the American Association for the Study of Liver Diseases

et al. 2021

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“…In the past two decades, treatment evolution has been elaborated from the perspective of alloimmunization (4)(5)(6)(7). Intravenous immunoglobulin (IVIG) and plasma exchange transfusion (ET) have replaced conventional cocktail therapy (1,2). The application of gestational IVIG also potentially prevents its recurrence in the next pregnancy (2,8,9).…”

Section: Introductionmentioning

confidence: 99%

“…Gestational alloimmune liver disease (GALD), currently regarded as a maternal–fetal alloimmune disorder, is a leading etiology of neonatal liver failure and neonatal hemochromatosis (NH) ( 1 ). Patients mostly present with congenital cirrhosis, whereas some develop hyperacute process, leading to stillbirth or demise ( 2 ).…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Intravenous Immunoglobulin/Exchange Transfusion Therapy on Gestational Alloimmune Liver Disease

et al. 2021

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Background: Gestational alloimmune liver disease (GALD) is a rare but critical cause of neonatal liver failure. After discovering the maternal–fetal alloimmune mechanism, intravenous immunoglobulin (IVIG) with or without exchange transfusion (ET) has gradually replaced antioxidant cocktails as the first-line therapy. Whether such therapy changes the outcome of neonates with GALD is yet to be defined.Method: We reported a pair of twins with discordant presentations, mild and self-limited in the older, whereas liver failure in the younger, who was successfully rescued by ET and IVIG. To investigate the outcome after therapeutic alteration, 39 cases between 2005 and 2020 from literature research were collected.Results: Half of the collected cases (47.1%) were preterm. Common presentations were ascites, jaundice, respiratory distress, hepatomegaly, and edema. Leading laboratory abnormalities were coagulopathy, hypoalbuminemia, and elevated serum ferritin. Salivary gland biopsy and magnetic resonance imaging detected extrahepatic siderosis in 70% (14/20) and 56% (14/25), respectively. IVIG, ET, and liver transplantation were performed in 19 (48.7%), 15 (38.5%), and 8 (20.5%) patients, respectively. The overall survival (OS) rate and native liver survival (NLS) rate were 64.1% (25/39) and 43.6% (17/39), respectively. Although the compiled results did not support a significant benefit, the OS and NLS were higher in the IVIG with/without ET group compared with those treated with conventional therapy [OS (70 vs. 57.9%) and NLS (55 vs. 31.6%), respectively].Conclusion: A high index of suspicion for GALD is crucial when facing a neonate with liver failure. Despite no significant influence on the outcome over conventional therapy in such a rare and detrimental disease, IVIG with or without ET can be worth trying before resorting to liver transplantation, which is resource-demanding and technique-challenging in small infants.

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“…Up to 90% of HBV infections acquired as a result of MTCT develop into chronic HBV. 1 Treatment reduces the risk for MTCT from 10% to 1%-2%.…”

mentioning

confidence: 99%

“…Increased risk with maternal viral load, HIV coinfection, prolonged rupture of membranes, and fetal scalp monitoring. 1 In the absence of these factors, risk is approximately 5%, and chronic HCV develops in 3% of infants.…”

mentioning

confidence: 99%

Viral Hepatitis in Pregnancy: An Update on Screening, Diagnosis, and Management

Sanghi

Lindenmeyer

2021

Clinical Liver Disease

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Viral hepatitis in pregnancy is common; accordingly, there is a need for evolved best practices in the approach to treatment of this special population. 1 Historically, the major limitation to standardization of evaluation and management of pregnant patients with viral hepatitis had been the availability of high-quality evidence and consensus expert opinion. In this article, we review the updated evidence for the screening, diagnosis, and management of acute and chronic viral hepatitis in pregnancy.Viral hepatitis in pregnancy increases the risk for pregnancy-related complications, as well as the risks associated with acute and chronic liver disease for both the mother and the infant as a result of mother-to-child transmission (MTCT) (Table 1). 1 A comprehensive and multidisciplinary approach to the management of viral hepatitis in pregnancy is necessary to reduce morbidity, mortality, and need for liver transplantation. This methodology involves early identification by screening, use of prevention techniques, encouragement of safe breastfeeding, treatment of infection, and immunoprophylaxis (Tables 1 and 2). HePaTiTis a virUsHepatitis A virus (HAV) typically has minimal impact on pregnancy. Testing in acute illness includes serum anti-HAV

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Liver Diseases in the Perinatal Period: Interactions Between Mother and Infant

Cited by 18 publications

References 55 publications

Reproductive Health and Liver Disease: Practice Guidance by the American Association for the Study of Liver Diseases

Reproductive Health and Liver Disease: Practice Guidance by the American Association for the Study of Liver Diseases

Efficacy of Intravenous Immunoglobulin/Exchange Transfusion Therapy on Gestational Alloimmune Liver Disease

Viral Hepatitis in Pregnancy: An Update on Screening, Diagnosis, and Management

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