Abstract
BackgroundAcute fatty liver of pregnancy (AFLP) is a potentially lethal condition of pregnant women with a high mortality rate. Potential predictors related to postpartum recovery time and prognostic factors of AFLP are still unclear. This study aimed to evaluate potential predictors for prognosis and postpartum recovery time of AFLP.MethodsWe retrospectively analyzed the clinical data of 76 AFLP patients in our hospital from 2002 to 2017 and investigated potential predictors using univariate analysis and multivariate logistic regression analysis.ResultsHepatic encephalopathy (HE) was found to be associated with prognosis in AFLP patients (P = 0.005, OR = 26.844). The postpartum recovery time analysis showed that AFLP patients with a age < 25 had the shortest recovery time, but no significant difference (P = 0.134, OR = 5.952). The postpartum recovery time of patients with liver failure (LF) was significantly prolonged compared to those without LF (P = 0.036, OR = 10.052). Cryoprecipitate, and plasma infusion showed no significant effect on prognosis or recovery time. Artificial liver support therapy (ALST) had no effect on prognosis, but it might affect postpartum recovery time with no statistical significance (P = 0.128, OR = 5.470).ConclusionHE is a potential predictor for prognosis of AFLP. LF is a potential predictor for postpartum recovery time.
Highlights
Acute fatty liver of pregnancy (AFLP) is a potentially lethal condition of pregnant women with a high mortality rate
This study found that patients younger than 25 years old had the fastest postpartum recovery compared with the other different maternal age, while those older than 29 years had a relatively longer postpartum recovery time
Our results showed that Acute kidney injury (AKI) does not affect the prognosis and postpartum recovery time for patients with AFLP
Summary
Acute fatty liver of pregnancy (AFLP) is a potentially lethal condition of pregnant women with a high mortality rate. Potential predictors related to postpartum recovery time and prognostic factors of AFLP are still unclear. This study aimed to evaluate potential predictors for prognosis and postpartum recovery time of AFLP. Acute fatty liver of pregnancy (AFLP) is an idiopathic disease occurring mainly in the third trimester of pregnancy and early postpartum period. AFLP develop rapidly, causing liver failure (LF) and severe complications which can affect maternal and fetal prognosis and lead to life threatening illness [6, 8]. Different studies showed inconsistent results on the risk factors related to prognosis in patients with AFLP. Meng J reported that total bilirubin (TBIL), prothrombin time (PT), fibrinogen (FIB) and platelet (PLT) were risk factors for the prognosis of patients with AFLP [9]. Zhu TX reported that TBIL, international normalized ratio (INR), serum creatinine (Scr), PLT and hepatic encephalopathy (HE) were related to the prognosis [10]
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