Autoimmune hepatitis and pregnancy

Abstract Autoimmune hepatitis (AIH) is a rare liver disease of autoimmune aetiology that classically affects women at reproductive age. The diagnosis of AIH is not always straightforward, and other causes of chronic liver disease must be excluded. The pregnancy in patients with AIH is associated with an increased risk of adverse maternal and foetal outcomes. In older studies, the incidence of adverse outcomes was high, with a large number of flare-ups, maternal deaths, and perinatal complications. In the most recent series, an improved care based on multidisciplinary surveillance, a larger number of patients treated before and during pregnancy, and a reduced incidence of cirrhosis at conception have led to better maternal outcomes and a live-birth rate similar to the general population. Nonetheless, AIH is still associated with preterm birth, foetal growth restriction, and unpredictable liver flares and represents a group of patients that need close evaluation during pregnancy.