标题： Outcome and risk factors of patients with acute fatty liver of pregnancy: a multicentre retrospective study.
作者： Gao, Qiang; Qu, Xin; Chen, Xiukai; Zhang, Jicheng; Liu, Fen; Tian, Suochen; Wang, Chunting
作者机构：[ Gao, Qiang; Gao Q] Department of Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China.;[ Qu, Xin; Qu 更多
来源： Singapore medical journal
摘要： INTRODUCTION: Acute fatty liver of pregnancy (AFLP) frequently causes liver failure in pregnant women. The relatively high mortality of AFLP behoves a better understanding of its clinical characteristics, management, outcomes and risk factors. We aimed to describe the characteristics of AFLP, and further assess its outcomes and potential risk factors from the perspectives of the mother and fetus. METHODS: This was a retrospective cohort study of 133 patients with AFLP hospitalised at four tertiary hospitals in China between January 2009 and April 2014. RESULTS: Among 133 patients with AFLP, for 13 (9.8%) patients, AFLP was diagnosed in the postpartum period. Male fetus (p = 0.04), postpartum diagnosis of AFLP (p < 0.01), intrauterine fetal death (p = 0.04), disseminated intravascular coagulation (p < 0.01), prothrombin time (p < 0.01) and activated partial thromboplastin time (p = 0.04) were potential factors influencing adverse maternal outcome. The frequency of fetal distress (p = 0.03) and activated partial thromboplastin time (p < 0.05) were significantly higher in pregnancies with dead fetuses than in those where the fetuses survived. Independent risk factors for perinatal maternal mortality were history of legalised termination of pregnancy (odds ratio [OR] 1.958, 95% confidence interval [CI] 1.133-3.385), total bilirubin (OR 1.009, 95% CI 1.003-1.014) and serum creatinine (OR 1.010, 95% CI 1.003-1.017). CONCLUSION: Compared with total bilirubin and serum creatinine, history of legalised termination of pregnancy appeared to be a greater risk factor for maternal mortality among patients with AFLP.