Y Joueidi1, K Peoc'h2, M Le Lous1, G Bouzille3, C Rousseau4, E Bardou-Jacquet5, C Bendavid6, L Damaj7, B Fromenty8, V Lavoué9, C Moreau10. 1. Service de Gynécologie obstétrique, Hôpital Sud CHU Rennes, France. 2. APHP, HUPNVS, UF de Biochimie Clinique, Hôpital Beaujon, F-91118, Clichy, France; Université de Paris, UFR de Médecine Xavier Bichat Centre de Recherche sur l'Inflammation (CRI), F-75018, Paris, France. 3. PMSI, Hôpital Pontchaillou CHU Rennes, 2 rue Henri Le Guilloux, 35000, Rennes, France. 4. Service de recherche clinique, Hôpital Pontchaillou CHU Rennes, 2 rue Henri Le Guilloux, 35000, Rennes, France. 5. Service d'Hépatologie, Hôpital Pontchaillou CHU Rennes, 2 rue Henri Le Guilloux, 35000, Rennes, France; Univ Rennes, INSERM, INRA, Institut NuMeCan, CHU Rennes, France. 6. Univ Rennes, INSERM, INRA, Institut NuMeCan, CHU Rennes, France; Laboratoire de Biochimie-Toxicologie, Hôpital Pontchaillou CHU Rennes, 2 rue Henri Le Guilloux, 35000, Rennes, France. 7. Service de Pédiatrie, Hôpital Sud, CHU Rennes Boulevard de Bulgarie, 35000, Rennes, France. 8. Univ Rennes, INSERM, INRA, Institut NuMeCan, CHU Rennes, France. 9. Service de Gynécologie obstétrique, Hôpital Sud CHU Rennes, France; Univ Rennes, CHU Rennes, INSERM, EHESP, IRSET (Institut de Recherche en Santé, Environnement et Travail) UMR_S 1085, F-35000, Rennes, France. 10. Laboratoire de Biochimie-Toxicologie, Hôpital Pontchaillou CHU Rennes, 2 rue Henri Le Guilloux, 35000, Rennes, France; Univ Rennes, CHU Rennes, INSERM, EHESP, IRSET (Institut de Recherche en Santé, Environnement et Travail) UMR_S 1085, F-35000, Rennes, France. Electronic address: caroline.moreau@chu-rennes.fr.
Abstract
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.
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.