For a study, researchers sought to discover critical epidemiologic variables related to biliary atresia that are crucial to fetal development.

This population-based registry research studied newborns born in Texas between 1999 and 2014. Poisson regression was used to compute prevalence ratios (PRs) and 95% CIs for instances of biliary atresia found in the Texas Birth Defects Registry (n=305) versus all live births (n=4,689,920).

During the research period, the prevalence of biliary atresia was 0.65 per 10,000 live births. Female sex was associated with biliary atresia (adjusted PR, 1.68; 95% CI, 1.33-2.12), delivery before 32-37 weeks of gestation (adjusted PR, 1.64; 95% CI, 1.18-2.29), delivery before 32 weeks of gestation (adjusted PR, 3.85; 95% CI, 2.38-6.22), and non-Hispanic Black vs. non-Hispanic (adjusted PR, 1.54, 95% CI, 1.06-2.24) while biliary atresia was inversely associated with the season of conception in the fall relative to spring (adjusted PR, 0.62; 95% CI, 0.45-0.86). Furthermore, biliary atresia was linked to maternal diabetes (adjusted PR, 2.34; 95% CI, 1.57-3.48), with a higher link with pregestational diabetes than gestational diabetes. These relationships were seen in solitary biliary atresia patients with no other birth abnormalities in subgroup analysis. 

Biliary atresia is linked to a number of fetal development variables, including pregestational maternal diabetes, female sex, and preterm delivery. These relationships were also seen in rare cases of biliary atresia that did not have any additional abnormalities or laterality problems. The findings were consistent with early life experiences impacting the pathogenesis of biliary atresia, and they lend support to future research into in utero events to better understand the etiology and timing of beginning.