FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W4283316522> ?p ?o ?g. }

• W4283316522 endingPage "794" @default.
• W4283316522 startingPage "792" @default.
• W4283316522 abstract "The incidence of chronic liver disease in women is rising,1NVSS. QuickStats: death rates for chronic liver disease and cirrhosis, by sex and age group—National Vital Statistics System, United States, 2000 and 2015.MMWR Morb Mortal Wkly Rep. 2017; 66: 1031Crossref PubMed Scopus (0) Google Scholar in large part because of the growing number of women with alcohol-related and nonalcoholic fatty liver disease.2Sarkar M. Djerboua M. Flemming J.A. NAFLD cirrhosis is rising among childbearing women and is the most common cause of cirrhosis in pregnancy.Clin Gastroenterol Hepatol. 2022; 20: e315-e318Abstract Full Text Full Text PDF PubMed Scopus (7) Google Scholar This translates into a disproportionate relative increase of chronic liver disease–related mortality among young female patients.3Bertha M. Shedden K. Mellinger J. Trends in the inpatient burden of alcohol-related liver disease among women hospitalized in the United States.Liver Int. 2022; 42: 1557-1561Crossref Scopus (6) Google Scholar Reflecting the rise of liver disease in this patient population, pregnancy rates in women with cirrhosis have more than doubled over the past decade.4Huang A.C. Grab J. Flemming J.A. et al.Pregnancies with cirrhosis are rising and associated with adverse maternal and perinatal outcomes.Am J Gastroenterol. 2022; 117: 445-452Crossref PubMed Scopus (2) Google Scholar Given the growing prevalence, incidence, and liver-related morbidity and mortality among patients of childbearing age, providers caring for these patients, including gastroenterologists, hepatologists, obstetricians, and advanced care practitioners, must be aware of the influence of liver disease on pregnancy outcomes, and vice versa, including implications of unintended pregnancies. Therefore, the recent overturning of Roe v Wade by the US Supreme Court merits discussion.5Totenberg N, McCammon S. Supreme court overturns Roe v. Wade, ending right to abortion upheld for decades. NPR News, June 24, 2022. Available at: https://www.npr.org/2022/06/24/1102305878/supreme-court-abortion-roe-v-wade-decision-overturn.Google Scholar Restricting reproductive options may compromise the health of many of our patients, particularly disadvantaged populations with a lower socioeconomic status and racial minorities.6The Lancet. Why Roe v. Wade must be defended.Lancet. 2022; 399: 1845Abstract Full Text Full Text PDF Scopus (9) Google Scholar In this commentary, we review the potential medical challenges in reproductive-aged patients with chronic liver disease because of the restricted access to abortions and if certain contraceptives, such as intrauterine devices (IUDs), become restricted. Based on recent data, 43 states require parental consent and/or notification for abortion services for minors, 30 states mandate a waiting period before abortion services, and only 17 states provide public funding for abortions.7Status of Women in the StatesInstitute for Women’s Policy Research.https://statusofwomendataorg/Date: 2016Date accessed: June 7, 2022Google Scholar Access to abortion depends on state-specific regulations, and more patients leave states with restrictive laws for abortion care.8Smith M.H. Muzyczka Z. Chakraborty P. et al.Abortion travel within the United States: an observational study of cross-state movement to obtain abortion care in 2017.Lancet Region Health Americas. 2022; : 1-10Google Scholar Figure 1 reflects the number of states that would likely ban or have banned abortion since Roe v Wade was overturned.9Buchholz K. Which states would end abortion if Roe v. Wade was overturned?.https://wwwstatistacom/chart/26955/reaction-to-roe-v-wade-overturned-by-state/Date accessed: June 7, 2022Google Scholar Furthermore, lawmakers in certain states expressed support for bills that would ban IUDs, which include copper and hormonal options that can be used for contraception, as well as emergency contraception after unprotected intercourse.10Aguilera J. Overturning Roe could lead to restrictions on birth control time.https://time.com/6175213/birth-control-after-roe-v-wade/Google Scholar The American Association for the Study of Liver Diseases guidance document recommends discussion of reproductive health with every female patient of childbearing age.11Sarkar M. Brady C.W. Fleckenstein J. et al.Reproductive health and liver disease: practice guidance by the American Association for the Study of Liver Diseases.Hepatology. 2021; 73: 318-365Crossref PubMed Scopus (35) Google Scholar Such discussion should inform patients of their unique pregnancy-related risks of liver disease exacerbation, increased risk of adverse pregnancy outcomes, and the need for distinct management and adjustment of liver-related medications before conception.4Huang A.C. Grab J. Flemming J.A. et al.Pregnancies with cirrhosis are rising and associated with adverse maternal and perinatal outcomes.Am J Gastroenterol. 2022; 117: 445-452Crossref PubMed Scopus (2) Google Scholar Healthy pregnancies in women with liver disease can be achieved, but multidisciplinary planning is critical for optimizing maternal and perinatal outcomes. Women who wish to avoid pregnancy should be counseled on the safety and efficacy of contraception, particularly in light of distinct risks of some agents with certain liver-related conditions. Contraception poses unique challenges in this patient population. Combined hormonal contraceptives are contraindicated in women with decompensated liver disease, Budd Chiari syndrome or hepatic adenomas.11Sarkar M. Brady C.W. Fleckenstein J. et al.Reproductive health and liver disease: practice guidance by the American Association for the Study of Liver Diseases.Hepatology. 2021; 73: 318-365Crossref PubMed Scopus (35) Google Scholar However, they can be used safely in all other patients with chronic liver disease and should not be routinely avoided in practice. Reproductive care poses a significant challenge in adolescents with liver disease as well. Up to two-thirds of all pregnancies among adolescents aged 15–19 years are unplanned.12Centers for Disease and PreventionUnintended pregnancy.https://www.cdc.gov/reproductivehealth/contraception/unintendedpregnancy/index.htmGoogle Scholar Adolescents may struggle with social supports and self-management of their chronic disease and will require multidisciplinary management of transition to adult care.13Piering K. Arnon R. Miloh T.A. et al.Developmental and disease-related influences on self-management acquisition among pediatric liver transplant recipients.Pediatr Transplant. 2011; 15: 819-826Crossref PubMed Scopus (8) Google Scholar Unplanned pregnancy in this fragile time in their lives can pose significant undue stress, and access to safe reproductive services is essential if they choose not to pursue pregnancy. Pregnancies in women with cirrhosis have an increased risk for hypertensive complications, postpartum hemorrhage, intrahepatic cholestasis of pregnancy, and risk for catastrophic variceal bleeding.4Huang A.C. Grab J. Flemming J.A. et al.Pregnancies with cirrhosis are rising and associated with adverse maternal and perinatal outcomes.Am J Gastroenterol. 2022; 117: 445-452Crossref PubMed Scopus (2) Google Scholar,14Westbrook R.H. Yeoman A.D. O'Grady J.G. et al.Model for end-stage liver disease score predicts outcome in cirrhotic patients during pregnancy.Clin Gastroenterol Hepatol. 2011; 9: 694-699Abstract Full Text Full Text PDF PubMed Scopus (84) Google Scholar,15Shaheen A.A. Myers R.P. The outcomes of pregnancy in patients with cirrhosis: a population-based study.Liver Int. 2010; 30: 275-283Crossref PubMed Scopus (103) Google Scholar Cirrhosis is also associated with higher rates of perinatal complications, including increased risk of preterm birth, infants who are large for gestational age, and neonatal respiratory distress.4Huang A.C. Grab J. Flemming J.A. et al.Pregnancies with cirrhosis are rising and associated with adverse maternal and perinatal outcomes.Am J Gastroenterol. 2022; 117: 445-452Crossref PubMed Scopus (2) Google Scholar,15Shaheen A.A. Myers R.P. The outcomes of pregnancy in patients with cirrhosis: a population-based study.Liver Int. 2010; 30: 275-283Crossref PubMed Scopus (103) Google Scholar,16Flemming J.A. Mullin M. Lu J. et al.Outcomes of pregnant women with cirrhosis and their infants in a population-based study.Gastroenterology. 2020; 159: 1752-1762Abstract Full Text Full Text PDF PubMed Scopus (28) Google Scholar Increased rates of splenic artery aneurism have been reported, with staggering maternal and fetal mortality risks of up to 90% and 70%, respectively.17Morton A. Splenic artery aneurysms, portal hypertension and pregnancy.J Hepatol. 2019; 70: 1025-1026Abstract Full Text Full Text PDF PubMed Scopus (6) Google Scholar Various medications used for management of chronic liver disease are not safe for pregnancy, such as mycophenolic acid products, which increase the risk of fetal malformations. For some medical centers, pregnancy is a contraindication to transplantation; thus, women who are listed for an organ and become pregnant will be automatically removed from the waitlist and deprived of a lifesaving option of liver transplantation. In the post-transplant setting, unplanned pregnancies are associated with increased risk of maternofetal complications.18Szpotanska-Sikorska M. Mazanowska N. Kociszewska-Najman B. et al.Unintended pregnancies and family planning among women after kidney or liver transplantation.J Matern Fetal Neonat Med. 2020; 33: 1346-1352PubMed Google Scholar Currently, it is recommended to delay pregnancy for liver transplant recipients to beyond the first year after transplantation to minimize the risk of rejection, infectious complications, and the immunosuppressive regimen.19McKay D.B. Josephson M.A. Armenti V.T. et al.Reproduction and transplantation: report on the AST Consensus Conference on Reproductive Issues and Transplantation.Am J Transplant. 2005; 5: 1592-1599Crossref PubMed Scopus (358) Google Scholar Therefore, patients with liver disease require full access to reproductive health care, which includes access to safe medical and surgical abortions. The implications of overturning Roe v Wade include not only the potential to reduce access to safe abortion care, but also will disproportionately affect those already at higher risk based on social determinants of health.20Foster D.G. Biggs M.A. Ralph L. et al.Socioeconomic outcomes of women who receive and women who are denied wanted abortions in the United States.Am J Public Health. 2018; 108: 407-413Crossref PubMed Scopus (141) Google Scholar There are additional implications for the legality of and access to contraception, such as IUDs.21Pengelly M. Mississippi governor refuses to rule out banning contraception.https://www.theguardian.com/us-news/2022/may/09/mississippi-governor-contraception-abortion-rightsGoogle Scholar IUDs have the lowest failure rate of any hormonal agent, other than subcutaneous implants, and so are a particularly good option for both efficacy and convenience and are safe for all forms of chronic liver disease.11Sarkar M. Brady C.W. Fleckenstein J. et al.Reproductive health and liver disease: practice guidance by the American Association for the Study of Liver Diseases.Hepatology. 2021; 73: 318-365Crossref PubMed Scopus (35) Google Scholar,22Sarkar M. Bramham K. Moritz M.J. et al.Reproductive health in women following abdominal organ transplant.Am J Transplant. 2018; 18: 1068-1076Crossref PubMed Scopus (33) Google Scholar So, what can we in the gastroenterology and hepatology community do to mitigate these challenges? First, now more than ever we need routine contraception and family planning discussions conducted by providers with all adolescents and reproductive-aged women with liver disease. We must step up efforts to decrease rates of unplanned pregnancies because these patients may not have access to pregnancy termination, even if that pregnancy will compromise the health of the mother and baby. Second, we must advocate for abortion care, emergency contraception, and IUD access for all women, especially those whose chronic liver disease poses a high risk for maternal and fetal complications. This can be achieved by supporting your local legislative representative, voting in the next election, and dispelling the myths about contraception risks in this patient population. Given the broad impact of laws limiting access to reproductive health care, many medical societies have issued statements in support of access to comprehensive care and information, including the American College of Obstetricians and Gynecologists and the American College of Physicians.23American College of Obstetricians and GynecologistsA message to the ACOG community regarding the future of abortion care and ACOG's role.https://wwwacogorg/news/news-articles/2022/05/a-message-to-the-acog-community-regarding-the-future-of-abortion-care-and-acogs-roleGoogle Scholar,24American College of PhysiciansACP update: women’s health & SCOTUS leak.https://wwwacponlineorg/acp-newsroom/acp-update-womens-health-scotus-leakGoogle Scholar As a hepatology and transplant medical community, we express our unwavering support to our colleagues who provide high-quality reproductive care services, including abortion access, to our patients. Access to reproductive health care is of paramount importance, and patient and provider discussions should focus on individualized medical assessments of risks and benefits that also honor patient values." @default.
• W4283316522 created "2022-06-24" @default.
• W4283316522 creator A5038062344 @default.
• W4283316522 creator A5061541954 @default.
• W4283316522 creator A5085770998 @default.
• W4283316522 date "2022-10-01" @default.
• W4283316522 modified "2023-10-16" @default.
• W4283316522 title "On the Importance of Safe Access to Reproductive Options for Adolescents and Women With Liver Disease" @default.
• W4283316522 cites W2034859527 @default.
• W4283316522 cites W2092895233 @default.
• W4283316522 cites W2136278077 @default.
• W4283316522 cites W2163805608 @default.
• W4283316522 cites W2788443088 @default.
• W4283316522 cites W2913067183 @default.
• W4283316522 cites W3048200302 @default.
• W4283316522 cites W3087419935 @default.
• W4283316522 cites W3122946632 @default.
• W4283316522 cites W4200182659 @default.
• W4283316522 cites W4224243206 @default.
• W4283316522 cites W4235072874 @default.
• W4283316522 cites W4280554656 @default.
• W4283316522 doi "https://doi.org/10.1053/j.gastro.2022.06.053" @default.
• W4283316522 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/35752297" @default.
• W4283316522 hasPublicationYear "2022" @default.
• W4283316522 type Work @default.
• W4283316522 citedByCount "1" @default.
• W4283316522 countsByYear W42833165222023 @default.
• W4283316522 crossrefType "journal-article" @default.
• W4283316522 hasAuthorship W4283316522A5038062344 @default.
• W4283316522 hasAuthorship W4283316522A5061541954 @default.
• W4283316522 hasAuthorship W4283316522A5085770998 @default.
• W4283316522 hasBestOaLocation W42833165221 @default.
• W4283316522 hasConcept C126322002 @default.
• W4283316522 hasConcept C131872663 @default.
• W4283316522 hasConcept C2777075537 @default.
• W4283316522 hasConcept C2779134260 @default.
• W4283316522 hasConcept C71924100 @default.
• W4283316522 hasConceptScore W4283316522C126322002 @default.
• W4283316522 hasConceptScore W4283316522C131872663 @default.
• W4283316522 hasConceptScore W4283316522C2777075537 @default.
• W4283316522 hasConceptScore W4283316522C2779134260 @default.
• W4283316522 hasConceptScore W4283316522C71924100 @default.
• W4283316522 hasIssue "4" @default.
• W4283316522 hasLocation W42833165221 @default.
• W4283316522 hasLocation W42833165222 @default.
• W4283316522 hasOpenAccess W4283316522 @default.
• W4283316522 hasPrimaryLocation W42833165221 @default.
• W4283316522 hasRelatedWork W1908294932 @default.
• W4283316522 hasRelatedWork W1994065767 @default.
• W4283316522 hasRelatedWork W2008722499 @default.
• W4283316522 hasRelatedWork W2121243833 @default.
• W4283316522 hasRelatedWork W2257083003 @default.
• W4283316522 hasRelatedWork W2891664938 @default.
• W4283316522 hasRelatedWork W3029680700 @default.
• W4283316522 hasRelatedWork W4206533174 @default.
• W4283316522 hasRelatedWork W4380898592 @default.
• W4283316522 hasRelatedWork W2490274124 @default.
• W4283316522 hasVolume "163" @default.
• W4283316522 isParatext "false" @default.
• W4283316522 isRetracted "false" @default.
• W4283316522 workType "article" @default.