- Wang W, Chiu F, Kuo T, Shao YJ. Maternal Prenatal Infections and Biliary Atresia in Offspring. JAMA Netw Open. 2024;7(1):e2350044. doi:10.1001/jamanetworkopen.2023.50044
Biliary atresia (BA) is a rare liver disease during childhood. The disease is one of the main reasons for liver transplantation in paediatric patients. BA pathogenesis has not yet been conclusively clarified, but there are various theories. The consensus is that the disease probably develops after viral infections in the neonatal period. This leads to inflammation and eventually fibrosis of hepatocytes and cholangiocytes.
However, there are also more studies that suggest that the development of BA already begins during pregnancy and in utero. Little research has been carried out into the role that an infection of the mother during the gestation period could play in this. A study team from Taiwan has focussed on precisely this topic.
Using Taiwan's insurance system, health data became available for almost the its population of around 23 million people. Over the predefined study period, the researchers were able to identify 447 children with BA. Almost 3,000 healthy children born during the same period were then randomly selected as controls. The study's aim was to find out whether an infection in the mother during pregnancy increases the risk of biliary atresia. The infections included were.
The researchers found that children whose mothers suffered from gastrointestinal, gynaecological, or urinary tract infections during pregnancy had a significantly increased risk of suffering from BA. No corresponding correlation could be established for the other bacterial and viral infections. Of particular interest: maternal infection in the third trimester was associated with a particularly high risk of BA.
The data suggest a link between maternal gastrointestinal or urogenital infections and the development of biliary atresia. Further studies could provide more information about the pathogenesis of the disease, but also reveal possibilities that could contribute to the prevention of the disease.