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Liver disease of pregnancy uncommon in US county

Researchers found liver disease of pregnancy to be uncommon among a cohort of women in Olmsted County, Minnesota, according to published findings.

“In this first population-based study of [liver disease of pregnancy] in the United States, the incidence of [liver disease of pregnancy] in this population is not as high as reported in the literature derived from Europe or U.S. tertiary referral centers,” the researchers wrote.

To investigate the epidemiology of liver diseases that develop during or unique to pregnancy, the researchers evaluated data of 247 women with liver diseases unique to pregnancy in Olmsted County, Minnesota, between 1996 and 2010 found in the Rochester Epidemiology Project database. Variables measured included incidence of liver diseases unique to pregnancy, as well as long-term maternal and fetal outcomes.

Over a median follow-up of 7 years, the incidence of liver diseases unique to pregnancy was 0.77%. Pre-eclampsia with liver dysfunction was the most common form (0.4%, n =134), followed by hemolysis, elevated liver enzymes and low-platelet count (HELLP) syndrome (0.23%, n = 72) and intrahepatic cholestasis of pregnancy (0.1%, n = 26). In addition, 14 had hyperemesis gravidarum with abnormal liver enzymes and one had acute fatty liver of pregnancy.

Clinical outcomes were worse among women with HELLP or pre-eclampsia compared with women with other disorders. Of the women with HELLP, 70% had a premature delivery, 4% had abruptio placentae, 3% had acute kidney injury and 3% had infant death, according to the research.

Among the women with pre-eclampsia, 56% had a premature delivery, 4% had abruptio placentae, 3% had acute kidney injury and 0.7% had infant death.

In addition, 14% of all women developed recurrent liver disease unique to pregnancy, in which women with initial hyperemesis gravidarum (36%) or intrahepatic cholestasis of pregnancy (35%) had the highest recurrence rates.

The researchers concluded: “Maternal and fetal outcomes in Olmsted County were better than those reported from other studies, but fetal mortality was still high. Women with pre-eclampsia or HELLP are at higher risk for peripartum complications and subsequent development of comorbidities.” – by Melinda Stevens

Disclosure: The researchers report no relevant financial disclosures.