Drug-Induced Liver Injury in Pregnancy: The U.S. Drug-Induced Liver Injury Network Experience.

Obstet Gynecol

Division of Liver Diseases and the Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York; Duke University School of Medicine and the Duke Clinical Research Institute, Durham, and Wake Forest University School of Medicine and Atrium Health Wake Forest Baptist, Winston-Salem, North Carolina; National Institutes of Health, Bethesda, Maryland; Indiana University School of Medicine, Indianapolis, Indiana; and Albert Einstein Medical Center, Philadelphia, Pennsylvania.

Published: June 2024

There are limited data on the causative agents and characteristics of drug-induced liver injury in pregnant individuals. Data from patients with drug-induced liver injury enrolled in the ongoing multicenter Drug-Induced Liver Injury Network between 2004 and 2022 and occurring during pregnancy or 6 months postpartum were reviewed and compared with cases of drug-induced liver injury in nonpregnant women of childbearing age. Among 325 individuals of childbearing age in the Drug-Induced Liver Injury Network, 16 cases of drug-induced liver injury (5%) occurred during pregnancy or postpartum. Compared with drug-induced liver injury in nonpregnant women, pregnancy-related drug-induced liver injury was more severe ( P <.05). One elective termination and three miscarriages were documented; there were no maternal deaths. We recommend that isoniazid for latent tuberculosis be deferred to the postpartum period whenever feasible and that β-blockers or calcium channel blockers rather than methyldopa be used for hypertension management during pregnancy.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11098677PMC
http://dx.doi.org/10.1097/AOG.0000000000005585DOI Listing

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