Auger Nathalie, Jutras Gabrielle, Paradis Gilles, Ayoub Aimina, Lewin Antoine, Maniraho Amanda, Potter Brian J
Health Innovation and Evaluation Hub, University of Montreal Hospital Research Centre, Montreal, QC, Canada.
Bureau d'information et d'études en santé des populations, Institut national de santé publique du Québec, Montreal, QC, Canada.
Int J Epidemiol. 2025 Apr 12;54(3). doi: 10.1093/ije/dyaf072.
Pre-eclampsia is associated with acute hepatic complications, but the risk of developing chronic liver disease is unclear. We determined whether pre-eclampsia was associated with chronic liver disease for up to three decades after pregnancy.
We conducted a longitudinal population-based cohort study of 1 460 099 pregnant women with and without pre-eclampsia in Quebec, Canada, between 1989 and 2022. The main exposure was pre-eclampsia in any pregnancy. Outcomes included hospitalization for liver disease during 26 275 081 person-years of follow-up after pregnancy. Using Cox regression models adjusted for age, comorbidity, and socio-economic disadvantage, we estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between pre-eclampsia and liver disease.
Women with pre-eclampsia had a higher incidence of hospitalization for liver disease than women without pre-eclampsia (119.3 vs. 61.5 per 100 000 person-years). During a median follow-up of 18.4 years, pre-eclampsia was associated with 1.85 times the risk of hospitalization for liver disease (95% CI 1.75-1.95). Early-onset pre-eclampsia (HR 2.36, 95% CI 2.04-2.74), superimposed pre-eclampsia (HR 2.78, 95% CI 2.30-3.36), and pre-eclampsia recurring in more than one pregnancy (HR 3.00, 95% CI 2.59-3.46) were strongly associated with liver hospitalization. Associations were present with several liver complications, including hepatic cirrhosis, chronic hepatitis, fatty liver disease, and hepatic failure. Pre-eclampsia was more strongly associated with hepatic hospitalization within 5 years of pregnancy, although risks persisted for up to 33 years later.
Pre-eclampsia is associated with the long-term risk of liver disease up to 33 years after pregnancy.
子痫前期与急性肝脏并发症相关，但发生慢性肝病的风险尚不清楚。我们确定了子痫前期在妊娠后长达三十年的时间里是否与慢性肝病相关。
我们对1989年至2022年期间加拿大魁北克省1460099名患有和未患子痫前期的孕妇进行了一项基于人群的纵向队列研究。主要暴露因素是任何一次妊娠中的子痫前期。结局包括妊娠后26275081人年随访期间因肝病住院情况。使用针对年龄、合并症和社会经济劣势进行调整的Cox回归模型，我们估计了子痫前期与肝病之间关联的风险比（HR）和95%置信区间（CI）。
子痫前期女性因肝病住院的发生率高于未患子痫前期的女性（每10万人年分别为119.3例和61.5例）。在中位随访18.4年期间，子痫前期与因肝病住院的风险增加1.85倍相关（95%CI 1.75 - 1.95）。早发型子痫前期（HR 2.36，95%CI 2.04 - 2.74）、叠加性子痫前期（HR 2.78，95%CI 2.30 - 3.36）以及在不止一次妊娠中复发的子痫前期（HR 3.00，95%CI 2.59 - 3.46）与肝病住院密切相关。与多种肝脏并发症相关，包括肝硬化、慢性肝炎、脂肪性肝病和肝衰竭。子痫前期与妊娠后5年内的肝病住院关联更强，尽管风险在33年后仍持续存在。
子痫前期与妊娠后长达33年的肝病长期风险相关。
