Association of maternal biliary disease with hepatopancreatobiliary morbidity in offspring

Objectives Maternal biliary disease is common, but the link with offspring hepatopancreatobiliary disease has not been studied. We assessed the association between maternal biliary disease and pediatric hepatopancreatobiliary morbidity. Methods We conducted a retrospective cohort study of 1,271,864 children born between 2006 and 2022 in Quebec, Canada. The exposure was maternal biliary disease. Offspring outcomes included congenital hepatopancreatobiliary anomalies, inborn errors of metabolism, and hepatopancreatobiliary morbidity between birth and age 17 years. We estimated adjusted risk ratios (RR) and hazard ratios (HR) with 95% confidence intervals (CI) for the association of maternal biliary disease with child outcomes. Results A total of 95,047 children (7.5%) had mothers with biliary disease. Compared with no exposure, maternal biliary disease was associated with an increased risk of bile duct defects (RR 1.67, 95% CI 1.10–2.52), liver defects (RR 1.47, 95% CI 1.05–2.06), and inborn errors of metabolism (RR 1.41, 95% CI 1.24–1.62) in offspring. Exposed children were more likely to be hospitalized for cholelithiasis, cholecystitis, or cholangitis (HR 2.58, 95% CI 2.14–3.12), acute pancreatitis (HR 1.83, 95% CI 1.38–2.43), and metabolic dysfunction‐associated steatotic liver disease (HR 2.71, 95% CI 2.07–3.54). Conclusions Maternal biliary disease is associated with hepatopancreatobiliary complications in offspring.