Pan Xiyu, Chu Ran, Qiao Xu, Zhang Xianru, Li Li, Zhang Wenxia
Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, Jinan, Shandong Province, People's Republic of China.
Department of Obstetrics and Gynecology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong Province, People's Republic of China.
Int J Womens Health. 2025 Jan 6;17:21-32. doi: 10.2147/IJWH.S477944. eCollection 2025.
To investigate the rare obstetric emergency with no specific treatments called acute fatty liver of pregnancy. The primary objective was to evaluate association of adverse perinatal outcomes with blood components transfusion. While the secondary objective focused on further establishing the predictive risk factors for adverse perinatal outcomes.
This retrospective cohort study included patients, who diagnosed with acute fatty liver of pregnancy without hepatic/malignant diseases in Qilu Hospital of Shandong University over 12-year period (collected 2007-2019, aged 20-41years). Chi-square test was used to explore the relevance between blood transfusion therapy and adverse perinatal outcomes. Meanwhile, logistic regression analysis was performed to identify predictive risk factors.
Of 146 patients, 26 (26/146, 17.8%) received prenatal blood transfusions. These patients had reduced gestational ages and exhibited more severe clinical symptoms. The association between blood transfusion and adverse maternal outcomes yielded a value of 0.044, while the association with fetal outcomes was highly significant (<0.001). Multivariate logistic regression analysis identified seven high-risk factors for maternal outcomes and six for fetal outcomes, all demonstrating strong discriminatory capacity.
Blood component transfusion may serve as a marker of disease severity. Prompt identification of patients with high-risk factors is crucial to improve maternal and fetal outcomes.
研究妊娠期急性脂肪肝这种无特定治疗方法的罕见产科急症。主要目的是评估围产期不良结局与输血之间的关联。次要目的则聚焦于进一步确定围产期不良结局的预测风险因素。
这项回顾性队列研究纳入了山东大学齐鲁医院12年间（2007年至2019年收集，年龄20至41岁）被诊断为妊娠期急性脂肪肝且无肝脏/恶性疾病的患者。采用卡方检验来探究输血治疗与围产期不良结局之间的相关性。同时，进行逻辑回归分析以确定预测风险因素。
在146例患者中，26例（26/146，17.8%）接受了产前输血。这些患者孕周缩短，临床症状更严重。输血与孕产妇不良结局之间的关联值为0.044，而与胎儿结局的关联高度显著（<0.001）。多因素逻辑回归分析确定了七个孕产妇结局的高危因素和六个胎儿结局的高危因素，均显示出很强的鉴别能力。
成分输血可能是疾病严重程度的一个标志。及时识别高危因素患者对于改善母婴结局至关重要。
