Liver transaminase enzyme analysis as a predictor of poor maternal outcome in pregnant women with dengue

Abstract

To find out predictive value of elevated liver transaminases as a predictor of poor maternal outcome in pregnant women with dengue infection.Our study was a retrospective study, conducted in a tertiary care centre of North India from July 1 to December 31, 2021. Data of all the pregnant women with dengue infection during the above period was screened for maternal and fetal outcomes. Elevated liver transaminases in women who developed DHF, DSS and maternal mortality were the main outcome measures. Mode of delivery, obstetric complications, medical complications (Dengue Hemorrhagic Fever, Dengue shock syndrome and Acute Respiratory Distress Syndrome) and KFT for prediction of maternal mortality were the secondary outcome measures.The association of liver transaminases derangement with stage of dengue at diagnosis were analysed using Fisher’s exact test. Data analysis was done with Statistical Package for Social Sciences (SPSS) software, IBM manufacturer, Chicago, USA, version 21. P value of less than 0.05 was considered statistically significant. A total of 35 women were included in the study. The mean age was 23.49 + 2.94 years. Acute respiratory distress syndrome, acute kidney injury, atonic PPH, and puerperal sepsis developed in 6(17.14%), 7(20%), 4(8.57%), and 10 (28.57%) women respectively. The maternal mortality rate was 25.71%. All women who developed DHF (3 women) and DSS (9 women) had altered liver enzymes. Alanine transaminase has very high sensitivity (100%) and specificity (76.92%) as a predictor of maternal mortality in pregnant women with dengue, (p<0.05). Similarly, serum creatinine levels at a value of more than 0.9 mg/dl had a sensitivity and specificity of 88.89% and 92.31%, respectively for predicting maternal mortality in pregnant women with dengue, (p<0.05). Conclusion: Elevated liver transaminases can be used as predictors of poor maternal outcome in pregnant women with dengue infection.