title: Pregnancy in primary sclerosing cholangitis.
abstract: BACKGROUND
  There is a paucity of data on fertility or pregnancy in patients with primary sclerosing cholangitis (PSC).
  
  
  OBJECTIVE
  To assess fertility in PSC by comparing the number of children in a large cohort of PSC patients to healthy controls and to investigate the outcome of pregnancy, as well as the influence of pregnancy on the disease course.
  
  
  METHODS
  Case series.
  
  
  METHODS
  Germany.
  
  
  METHODS
  229 PSC patients and 569 healthy controls were evaluated for the number of children. 17 patients with PSC and at least one pregnancy, or who received a diagnosis of PSC within 6 months after delivery, were included in the more detailed analysis.
  
  
  METHODS
  Number of children per patient and control; disease activity during pregnancy and after delivery including maternal complications; long-term development of live births, fetal loss rate and the influence of medication on fetal and maternal outcome.
  
  
  RESULTS
  Fertility did not seem to be reduced in PSC since the number of children did not differ between PSC patients and healthy controls. 25 pregnancies in 17 female PSC patients (median age at conception 31 years) were investigated in detail. An increase in liver enzymes was documented during five pregnancies (20%) and eight times (32%) post-partum. There were no serious maternal complications. All 21 live births presented with a normal perinatal and postnatal development over a median observation time of 50 months. Two pregnancies were delivered pre-term and four fetal losses occurred early in pregnancy (<12 wk). Continuation of treatment with ursodeoxycholic acid (15/21) or azathioprine (2/21) had no negative effects on pregnancy outcome.
  
  
  CONCLUSIONS
  Fertility does not seem to be reduced in patients with PSC, who are able to deliver healthy children without an apparent increase in risk for mother or child.
authors.affiliation: Department of Medicine, University Medical Center Hamburg-Eppendorf, Martinistr, Hamburg 20246, Germany.
authors.forename: Björn E
authors.initials: BE
authors.lastname: Wellge
authors.forename: Martina
authors.initials: M
authors.lastname: Sterneck
authors.forename: Andreas
authors.initials: A
authors.lastname: Teufel
authors.forename: Christian
authors.initials: C
authors.lastname: Rust
authors.forename: Andre
authors.initials: A
authors.lastname: Franke
authors.forename: Stefan
authors.initials: S
authors.lastname: Schreiber
authors.forename: Thomas
authors.initials: T
authors.lastname: Berg
authors.forename: Rainer
authors.initials: R
authors.lastname: Günther
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Kreisel
authors.forename: Christine
authors.initials: C
authors.lastname: Zu Eulenburg
authors.forename: Felix
authors.initials: F
authors.lastname: Braun
authors.forename: Ulrich
authors.initials: U
authors.lastname: Beuers
authors.forename: Peter R
authors.initials: PR
authors.lastname: Galle
authors.forename: Ansgar W
authors.initials: AW
authors.lastname: Lohse
authors.forename: Christoph
authors.initials: C
authors.lastname: Schramm
mesh_terms: D000293:Adolescent; D000328:Adult; D001379:Azathioprine / Q000627:therapeutic use; D002756:Cholagogues and Choleretics / Q000627:therapeutic use; D015209:Cholangitis, Sclerosing / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D015994:Incidence; D007231:Infant, Newborn; D011247:Pregnancy; D011248:Pregnancy Complications; D011256:Pregnancy Outcome; D012307:Risk Factors; D013997:Time Factors; D014580:Ursodeoxycholic Acid / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D002756:Cholagogues and Choleretics; D007166:Immunosuppressive Agents; D014580:Ursodeoxycholic Acid; D001379:Azathioprine