Maternal and neonatal outcomes and prognostic factors in acute fatty liver of pregnancy

Y. Joueidi (1) , K. Peoc'H (2) , Maela Le Lous (1) , Guillaume Bouzille (1) , Chloé Rousseau (1) , Edouard Bardou-Jacquet (3, 1) , Claude Bendavid (3, 1) , L Damaj (1) , B. Fromenty (3) , Vincent Lavoué (4, 1) , Caroline Moreau (4, 1)

1 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
2 Hôpital Beaujon
3 NuMeCan - Nutrition, Métabolismes et Cancer
4 Irset - Institut de recherche en santé, environnement et travail

Objective To report complications of Acute Fatty Liver of pregnancy (AFLP), a rare liver disease of pregnancy, and identify prognostic factors for mothers and children. Study Design We conducted a retrospective descriptive study over 18 years in three French maternities. Demographic, clinical, biological data, and outcomes of patients and their infants were reviewed. Results 142,450 pregnancies from centers were studied. Eighteen patients with AFLP were identified The prevalence of AFLP was estimated as 1/7,914 pregnancies. Prolonged prothrombin time was identified as a risk factor of maternal complications (OR = 0.86, p = 0.0493). Gestational age at delivery was the only risk factor associated with fetal or neonate complications (OR = 0.37, p = 0.0417). One boy died of previously undiagnosed β-oxidation deficiency at eight months. Conclusion In AFLP, prothrombin time must be carefully monitored to anticipate major maternal complications. Infants born to mothers with ALFP should be screened as early as possible for mitochondrial fatty acid oxidation deficiency. © 2020 Elsevier B.V.

Mots clés: Acute fatty liver of pregnancy; Delivery; Fetal and maternal outcomes; Liver; Metabolic disease; Swansea criteria

Domaines: Sciences du Vivant [q-bio]

Y. Joueidi, K. Peoc'H, Maela Le Lous, Guillaume Bouzille, Chloé Rousseau, et al.. Maternal and neonatal outcomes and prognostic factors in acute fatty liver of pregnancy. European Journal of Obstetrics & Gynecology and Reproductive Biology, 2020, 252, pp.198-205. ⟨10.1016/j.ejogrb.2020.06.052⟩. ⟨hal-02931946⟩