Potential predictors for prognosis and postpartum recovery time of acute fatty liver of pregnancy
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(2020) 20:601
RESEARCH ARTICLE
Open Access
Potential predictors for prognosis and postpartum recovery time of acute fatty liver of pregnancy Jun Chen1,2†, Ze-Bing Huang1,2†, Xue-Gong Fan1,2, Xing-Wang Hu1,2, Min Qi1,2, Cheng-Jin Liao1,2, Li-Yuan Long1,2 and Yan Huang1,2*
Abstract Background: 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. Methods: We 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. Results: Hepatic 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). Conclusion: HE is a potential predictor for prognosis of AFLP. LF is a potential predictor for postpartum recovery time. Keywords: Acute fatty liver of pregnancy, Potential predictors, Prognosis, Postpartum recovery time
Background Acute fatty liver of pregnancy (AFLP) is an idiopathic disease occurring mainly in the third trimester of pregnancy and early postpartum period. The 34th gestation week is the critical time for screening AFLP outpatients [1]. Pathologically, AFLP is characterized by hepatocyte fat infiltration, degeneration and necrosis [2]. Clinically, patients often have non-specific clinical manifestations such as fatigue, jaundice, bleeding, and gastrointestinal * Correspondence: [email protected] † Jun Chen and Ze-Bing Huang contributed equally to this work. 1 Department of Infectious Diseases, Xiangya Hospital, Central South University, Kaifu District, Xiangya Road 87, Changsha 410008, China 2 Key Laboratory of Viral Hepatitis, Changsha, Hunan, China
symptoms. Although the incidence of AFLP is as low as 1/7000 to 1/16,000 pregnancies [3–5], the maternal mortality rate is as high as 7 to 18% [6, 7]. 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]. Currently, 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)
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