Epidemiologic Trends in Acute, Chronic, and Pregnancy-Specific Liver Diseases in Pregnancy
Bibliographic record
Abstract
INTRODUCTION: Chronic liver diseases (CLDs) and cirrhosis are rising in reproductive-aged female patients, primarily driven by increasing alcohol-related liver disease and metabolic dysfunction-associated steatotic liver disease (MASLD). However, contemporary data on acute, chronic, and pregnancy-specific liver diseases remain limited. METHODS: This 10-year retrospective study at a tertiary center included all pregnancies from January 1, 2014, to December 31, 2023. Liver conditions-categorized as acute, chronic, and pregnancy-specific-were identified by diagnosis codes. Sociodemographic and pregnancy-related data were collected from electronic medical records. Group comparisons were performed using the χ 2 and Student t tests. Temporal trends were assessed through the Cochrane-Armitage test. RESULTS: Among 51,708 pregnancies, 1,429 (2.8%) were affected by 1 or more liver condition: 85 (4.8%) with acute, 913 (51.8%) with CLD including 77 (4.4%) with cirrhosis, and 784 (44.5%) with pregnancy-specific liver diseases (e.g., intrahepatic cholestasis of pregnancy; acute fatty liver of pregnancy; hemolysis, elevated liver enzymes, and low platelets syndrome; and preeclampsia with liver involvement). Prevalent CLD in pregnancy increased over time, with a shift from chronic viral hepatitis to MASLD ( P values <0.01). Pregnancy-specific liver conditions remained stable over time, though occurred more commonly in those with concurrent CLD (intrahepatic cholestasis of pregnancy 3.2% vs 0.6%; preeclampsia 11.3% vs 6.3%; hemolysis, elevated liver enzymes, and low platelets syndrome 0.6% vs 0.2%; and acute fatty liver of pregnancy 0.2% vs 0.0%; all P < 0.01). DISCUSSION: In this large epidemiologic study, we observed a 2.5-fold rise in CLD in pregnancy over the past 10 years, largely driven by the rising prevalence of MASLD, and declining prevalence of chronic viral hepatitis. Pregnancy-specific liver conditions were also significantly more common in those with CLD. Findings underscore the relevance of preconception counseling by hepatology providers and the importance of early obstetric collaboration to optimize outcomes for the growing number of pregnant women with preexisting liver disease.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".