Risk of recurrent acute fatty liver of pregnancy: survey from a social media group

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Background
Acute fatty liver of pregnancy (AFLP) is a rare but serious complication in the last trimester of pregnancy or post partum period. Data on the recurrence risk are largely unavailable as only case reports or very small case series exist in which one single woman had recurrent AFLP.

Objective
We aimed to estimate the risk of AFLP recurrence and to compare disease severity and gestational age between primary and recurrent disease using patient-provided data from an AFLP social media patient group.

Study Design
We developed and distributed an electronic questionnaire through an international Facebook group called “Acute Fatty Liver of Pregnancy”. The data collection took place from June 11 2018 to August 17 2018 using REDCap. Our main outcome measures were recurrence of AFLP, severity with recurrence and gestational age at delivery.

Results
Sixty-nine women with previous AFLP completed the questionnaire; 24 women had a subsequent delivery of which five women were diagnosed with AFLP again. In four out of five of these women (80%) AFLP took a milder course, whereas in one woman it worsened in the next pregnancy. Women with AFLP recurrence delivered at a median gestational age at 265 days (interquartile range (iqr) 242-287) in their first AFLP pregnancy as compared to delivery by a prelabor cesarean section at 245 days (iqr 235-261) in their second AFLP pregnancy. Male fetal gender was not associated with an increased risk of recurrent AFLP.

Conclusion
One in five women report having had recurrent AFLP with most cases being milder, possibly due to an earlier gestational age at delivery.
Original languageDanish
Article number100085
JournalAmerican Journal of Obstetrics & Gynecology MFM
ISSN2589-9333
DOIs
Publication statusPublished - May 2020
Event The 2019 Royal College of Obstetricians and Gynecologists World Congress - London, United Kingdom
Duration: 17 Jun 201919 Jun 2019

Conference

Conference The 2019 Royal College of Obstetricians and Gynecologists World Congress
CountryUnited Kingdom
CityLondon
Period17/06/201919/06/2019

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