Division of Pediatric Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN.
Division of Pediatric Gastroenterology and Hepatology, Boston Children's Hospital, Harvard Medical School, Boston, MA.
Hepatology. 2020 Apr;71(4):1474-1485. doi: 10.1002/hep.31109. Epub 2020 Mar 18.
Liver diseases affecting the mother and infant dyad may present in the perinatal period from 20 weeks of gestation to 28 days of life. This review will focus on the current approach to neonatal acute liver failure and the progress made in the diagnosis and management of gestational alloimmune liver disease. It will highlight mother-to-child transmission of viral hepatitis, both management and public health implications. Emerging concepts implicating maternal obesity and nutrition in the development of a rapidly progressive nonalcoholic steatohepatitis phenotype in the offspring will be discussed. Finally, the presentation and management of acute fatty liver of pregnancy and intrahepatic cholestasis of pregnancy, and their impact on the fetus, will be reviewed.
影响母婴对子的肝脏疾病可能在围产期出现,时间范围从妊娠 20 周持续到出生后 28 天。本篇综述将重点关注新生儿急性肝衰竭的当前处理方法,以及妊娠同种免疫性肝病的诊断和管理方面的进展。它将突出病毒性肝炎的母婴传播,包括管理和公共卫生方面的影响。本文还将讨论涉及母体肥胖和营养在后代中迅速发展的非酒精性脂肪性肝炎表型中的作用的新兴概念。最后,将综述妊娠急性脂肪肝和妊娠肝内胆汁淤积症的表现和处理,以及它们对胎儿的影响。