Autoimmune hepatitis during pregnancy: epidemiology, clinical manifestations, diagnosis, therapy, maternal and perinatal outcomes
Olenev A.S., Meretukova M.A., Shalina R.I., Kurtenok N.V., Kucherova O.N., Petrova N.A.
Autoimmune hepatitis (AIH) is an evolving liver disease characterized by aminotransferase and IgG level increase in blood serum, presence of autoantibodies and histological features of hepatitis in the absence of known etiology. AIH is associated with an increased risk of preterm birth, hypertensive disorders, and gestational diabetes. This condition is also the cause of an increased cesarean section rate. In addition to adverse maternal outcomes cirrhosis negatively impacts the fetus, reducing live birth rates among patients with AIH. Data on the course of pregnancy with AIH are limited with few studies presented. Clinical guidelines for the management of AIH during pregnancy have not been developed, and there is an insufficient number of studies demonstrating pregnancy outcomes among patients with AIH. Apart from this, the incidence of AIH during pregnancy is increasing due to advanced diagnosis methods, pathogenetically based treatment, and prenatal and postnatal monitoring.
This study is aimed at the analysis of current data on the epidemiology, classification, diagnosis, treatment, and delivery methods in patients with AIH during pregnancy. We also present data on maternal and perinatal outcomes in pregnant women. Moreover, here we discuss modern approaches to pregnancy and postpartum care for AIH.
Conclusion: Timely diagnosis, adequate treatment and careful management of pregnancy in patients with AIH significantly reduce the risk of complications and improve both maternal and perinatal outcomes. Further study of the course of pregnancy in AIH, maternal and perinatal outcomes, as well as the influence of pregnancy on the course of the disease is paramount, since the data obtained may contribute to the development of preventive, diagnostic and therapeutic strategies.
Authors’ contributions: Olenev A.S., Shalina R.I., Kurtenok N.V. – manuscript editing; Meretukova M.A. – study concept, search and analysis of literature data, manuscript conduction; Kucherova O.N., Petrova N.A. – search and analysis of literature data.
Conflicts of interest: The authors declare no conflict of interests.
Funding: The study had no sponsorship support.
For citation: Olenev A.S., Meretukova M.A., Shalina R.I., Kurtenok N.V., Kucherova O.N., Petrova N.A. Autoimmune hepatitis during pregnancy: epidemiology, clinical manifestations, diagnosis, therapy, maternal and perinatal outcomes.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2025; (11): 16-25 (in Russian)
https://dx.doi.org/10.18565/aig.2025.187
Keywords
autoimmune hepatitis
drug-induced liver injury
primary biliary cirrhosis
primary sclerosing cholangitis
prednisolone
azathioprine
ANA autoantibodies
SMA autoantibodies
anti-LKM1 autoantibodies
anti-SLA/LP autoantibodies
liver cirrhosis
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Received 07.07.2025
Accepted 25.11.2025
About the Authors
Anton S. Olenev, Dr. Med. Sci., Chief Freelance Specialist in Obstetrics, Deputy Chief Physician for Obstetric and Gynecological Care, Academician G.M. Savelieva Clinical Hospital No. 31, Moscow Healthcare Department, 119421, Russia, Moscow, Novatorov str., 3, +7(495)936-14-63, olenevAS@zdrav.mos.ru,https://orcid.org/0000-0001-9632-6731
Madina A. Meretukova, PhD, Associate Professor, Department of Obstetrics and Gynecology named after Academician G.M. Savelieva of the Institute of Continuing Medical Education, Pirogov Russian National Research Medical University, Ministry of Health of Russia, 117513, Russia, Moscow, Ostrovityanova str., 1, +7(905)501-05-32, pochtamadina@mail.ru, https://orcid.org/0009-0000-5284-1256
Raisa I. Shalina, Dr. Med. Sci., Professor, Department of Obstetrics and Gynecology named after Academician G.M. Savelieva of the Institute of Continuing Medical Education, Pirogov Russian National Research Medical University, Ministry of Health of Russia, 117997, Russia, Moscow, Ostrovityanova str., 1, +7(495)718-34-72, shalina_ri@rsmu.ru, https://orcid.org/0000-0001-7121-1663
Natalia V. Kurtenok, PhD, Head of the Perinatal Center, Academician G.M. Savelieva Clinical Hospital No. 31, Moscow Healthcare Department, 119421, Russia, Moscow, Novatorov str., 3, +7(495)936-14-63, nkurtenok@mail.ru, https://orcid.org/0009-0009-6703-4962
Olga N. Kucherova, PhD, Head of the Maternity Department of the Perinatal Center, Academician G.M. Savelieva Clinical Hospital No. 31, Moscow Healthcare Department, Obstetrician-Gynecologist, 119421, Russia, Moscow, Novatorov str., 3, +7(495)936-14-63, ola-kucherova@mail.ru, https://orcid.org/0000-0003-3773-9629
Nadezhda A. Petrova, Resident Physician, Department of Obstetrics and Gynecology named after Academician G.M. Savelieva, Institute of Continuing Medical Education, Pirogov Russian National Research Medical University, Ministry of Health of Russia, 117997, Russia, Moscow, Ostrovityanova str., 1, +7(967)473-91-94,
nogaderova@gmail.com, https://orcid.org/0000-0002-3681-4060
Corresponding author: Madina A. Meretukova, pochtamadina@mail.ru
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