ORIGINAL ARTICLE Mothers with Alcoholic Liver Disease and the Risk for Preterm and Small-for-gestational-age Birth

Aims: To study pregnancy outcome in women with alcoholic liver disease (ALD). Methods: Using the Swedish nation-wide Patient and Medical Birth Registers, we investigated risk of adverse pregnancy outcome in 720 women diagnosed with ALD before and 1720 diagnosed after birth and compared them with 24 460 population-based control births. Results: Women with ALD diagnosed before or after birth were generally of higher age and body mass index, more likely to smoke cigarettes during preg- nancy and to have a low socio-economic status compared with controls. Women diagnosed with ALD before birth had an increased risk of moderately and very preterm birth, adjusted odd ratio (OR) = 1.53 (95% confidence interval (CI): 1.37-1.72 and 1.15-2.06 95%), respectively. Infants of mothers with ALD before birth were more often small-for-gestational age, adjusted OR = 1.22 (95% CI: 1.05-1.43), and were at increased risk for low Apgar scores (<7) at 5 min, adjusted OR = 1.49 (95% CI: 1.15-1.92) compared with controls. Similar associations with slightly lower-risk estimates were found among women diagnosed with ALD after birth. Conclusions: ALD is associated with adverse-birth outcomes, highlighting the importance of screening women for alcohol depend- ence in antenatal care.