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Zhang M, Fu S, Ren D, Wu Y, Yao N, Ni T, Feng Y, Chen Y, Chen T, Zhao Y, Liu J. Maternal and Fetal Outcomes After Interferon Exposure During Pregnancy: A Systematic Review With Meta-Analysis. FRONTIERS IN REPRODUCTIVE HEALTH 2021; 3:702929. [PMID: 36303990 PMCID: PMC9580814 DOI: 10.3389/frph.2021.702929] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 07/12/2021] [Indexed: 12/30/2022] Open
Abstract
Interferon (IFN) treatment is widely applied in viral hepatitis and multiple myeloproliferative diseases. However, there is considerable controversy on how to deal with unintended pregnancy during IFN treatment, even selective termination is suggested by hepatologists. To settle this clinical dilemma, we conducted a systematic review to retrieve all published articles involving IFN exposure during pregnancy up until March 31, 2021. Only 8 case reports that were relevant with outcomes of pregnant women with viral hepatitis exposed to IFN-α were retrieved, and 17 studies reporting pregnancy outcomes after exposure to type I IFNs involving 3,543 pregnancies were eligible for meta-analysis. No birth defect was reported in the case reports of pregnant women with viral hepatitis. The meta-analysis showed that risks of pregnancy outcomes and birth defects were not increased after exposure to IFN-α. Further comprehensive meta-analysis concerning the IFN-α and IFN-β exposure demonstrated that the risks of live birth (OR 0.89, 95% CI: 0.62-1.27), spontaneous abortion (OR 1.09, 95% CI: 0.73-1.63), stillbirth (OR 1.38, 95% CI: 0.51-3.72), preterm delivery (OR 1.24, 95% CI: 0.85-1.81), and maternal complications (OR 0.72, 95% CI: 0.38-1.38) were not increased in patients exposed to IFNs. The pooled estimates of live birth, spontaneous abortion, stillbirth, preterm delivery, and maternal complications were 85.2, 9.4, 0, 7.5, and 6.5%, respectively. Importantly, the risk of birth defects was not increased (OR 0.68, 95% CI: 0.39-1.20) after IFN exposure, with a pooled rate of 0.51%. Therefore, IFN exposure does not increase the prevalence of spontaneous abortion, stillbirth, preterm delivery, and birth defects. Clinical decision should be made after weighing up all the evidence.
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Affiliation(s)
- Mengmeng Zhang
- Department of Infectious Diseases, The First Affiliated Hospital of Xi'an Jiao Tong University, Xi'an, China
- Department of Infectious Diseases, Xi'an, China
| | - Shan Fu
- Department of Infectious Diseases, The First Affiliated Hospital of Xi'an Jiao Tong University, Xi'an, China
- Department of Infectious Diseases, Xi'an, China
| | - Danfeng Ren
- Department of Infectious Diseases, The First Affiliated Hospital of Xi'an Jiao Tong University, Xi'an, China
- Department of Infectious Diseases, Xi'an, China
| | - Yuchao Wu
- Department of Infectious Diseases, The First Affiliated Hospital of Xi'an Jiao Tong University, Xi'an, China
- Department of Infectious Diseases, Xi'an, China
| | - Naijuan Yao
- Department of Infectious Diseases, The First Affiliated Hospital of Xi'an Jiao Tong University, Xi'an, China
- Department of Infectious Diseases, Xi'an, China
| | - Tianzhi Ni
- Department of Infectious Diseases, The First Affiliated Hospital of Xi'an Jiao Tong University, Xi'an, China
- Department of Infectious Diseases, Xi'an, China
| | - YaLi Feng
- Department of Infectious Diseases, The First Affiliated Hospital of Xi'an Jiao Tong University, Xi'an, China
- Department of Infectious Diseases, Xi'an, China
| | - Yaolong Chen
- Evidence-Based Medicine Center, Basic Medical Sciences, Lanzhou University, Lanzhou, China
- WHO Collaborating Center for Guideline Implementation and Knowledge Translation, Lanzhou, China
| | - Tianyan Chen
- Department of Infectious Diseases, The First Affiliated Hospital of Xi'an Jiao Tong University, Xi'an, China
- Department of Infectious Diseases, Xi'an, China
| | - Yingren Zhao
- Department of Infectious Diseases, The First Affiliated Hospital of Xi'an Jiao Tong University, Xi'an, China
- Department of Infectious Diseases, Xi'an, China
| | - Jinfeng Liu
- Department of Infectious Diseases, The First Affiliated Hospital of Xi'an Jiao Tong University, Xi'an, China
- Department of Infectious Diseases, Xi'an, China
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Koh M, Shinohara J, Hongo Y, Okazaki T, Takitani K, Tamai H. Author's Reply. Hepatol Res 2014; 44:593-5. [PMID: 24738987 DOI: 10.1111/hepr.12187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Maki Koh
- Department of Pediatrics, Hirakata City Hospital, Hirakata, Japan; Department of Pediatrics, Osaka Medical Collage, Takatsuki, Japan
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Karabay O, Leblebicioglu H. Interferon-beta, prednisolone and lamivudine combination in acute exacerbation of chronic hepatitis B during pregnancy. Hepatol Res 2014; 44:593. [PMID: 23639133 DOI: 10.1111/hepr.12154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Oguz Karabay
- Department of Infectious Diseases, Health Sciences Institute, Sakarya University, Sakarya
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Durazzo M, Belci P, Collo A, Prandi V, Pistone E, Martorana M, Gambino R, Bo S. Gender specific medicine in liver diseases: A point of view. World J Gastroenterol 2014; 20:2127-2135. [PMID: 24605011 PMCID: PMC3942817 DOI: 10.3748/wjg.v20.i9.2127] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2013] [Revised: 11/01/2013] [Accepted: 12/06/2013] [Indexed: 02/06/2023] Open
Abstract
Gender medicine focuses on the patho-physiological, clinical, prevention and treatment differences in diseases that are equally represented in men and women. The purpose of gender medicine is to ensure that each individual man and woman receives the best treatment possible based on scientific evidence. The concept of “gender” includes not only the sexual characteristics of individuals but also physiological and psychological attributes of men and women, including risk factors, protective/aggravating effects of sexual hormones and variances linked to genetics and corporal structures that explain biological and physiological differences between men and women. It is very important to consider all the biological, physiological, functional, psychological, social and cultural characteristics to provide patients with individualized disease management. Herein, we critically analyze the literature regarding gender differences for diseases and acquired conditions of the most representative hepatic pathologies: primary biliary cirrhosis, autoimmune hepatitis, primary sclerosing cholangitis, non alcoholic fatty liver disease and alcoholic liver disease, and viral chronic hepatitis B and C. The last section addresses hemochromatosis, which is a prevalent iron overload disorder in the Caucasian population. This review aims to describe data from the literature concerning viral chronic hepatitis during pregnancy, management during pregnancy and delivery, and new effective drugs for the prevention of maternal infection transmission without significant adverse effects or complications.
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Yamada K, Suda T, Komoro YS, Kanefuji T, Kubota T, Murayama T, Nakayama H, Aoyagi Y. Low fat intake is associated with pathological manifestations and poor recovery in patients with hepatocellular carcinoma. Nutr J 2013; 12:79. [PMID: 23758691 PMCID: PMC3691615 DOI: 10.1186/1475-2891-12-79] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2012] [Accepted: 06/04/2013] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND This study aimed to clarify whether dietary deviation is associated with pathological manifestations in hepatocellular carcinoma (HCC) patients. METHODS Dietary intake was estimated in 35 HCC cases before and after hospitalization by referencing digital camera images of each meal. Pathological conditions were evaluated in nitrogen balance, non-protein respiratory quotient (npRQ), neuropsychiatric testing and recovery speed from HCC treatment. RESULTS On admission, nitrogen balance and npRQ were negative and less than 0.85, respectively. Five patients were judged to have suffered from minimal hepatic encephalopathy that tended to be associated with a lowered value of npRQ (p = 0.082). The energy from fat intake showed a tendency of positive correlation with npRQ (p = 0.11), and the patients with minimal hepatic encephalopathy took significantly fewer energy from fat (p = 0.024). The energy difference from fat between diets at home versus those in the hospital showed a significant positive correlation with npRQ change after admission (p = 0.014). The recovery speed from invasive treatments for HCC showed a significant negative correlation with npRQ alteration after admission (p = 0.0002, r = -0.73). CONCLUSIONS These results suggest the lower fat intake leads to deterioration of energy state in HCC patients, which associates with poor recovery from invasive treatments and various pathological manifestations.
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Affiliation(s)
- Kazuki Yamada
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8122, Japan
| | - Takeshi Suda
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8122, Japan
| | - Yuko S Komoro
- Nutrition Control Center, Niigata University Medical and Dental Hospital, Niigata 951-8520, Japan
| | - Tsutomu Kanefuji
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8122, Japan
| | - Tomoyuki Kubota
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8122, Japan
| | - Toshiko Murayama
- Nutrition Control Center, Niigata University Medical and Dental Hospital, Niigata 951-8520, Japan
| | - Hideaki Nakayama
- Division of Pneumology, Niigata University Medical and Dental Hospital, Niigata 951-8520, Japan
| | - Yutaka Aoyagi
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8122, Japan
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