Etiological analysis and clinical outcome evaluation of abnormal liver function in pregnant women in early pregnancy

Abstract

Abstract: Objective To analyze the causes of abnormal liver function in pregnant women in early pregnancy and evaluate its clinical outcome.Methods 104 cases of abnormal liver function in early pregnancy admitted to our hospital between January 2022 and December 2024 were included. The causes were analyzed and the changes in liver function indexes before and after treatment were compared. The cases of immunological detection and liver biopsy were analyzed, and the clinical outcome was finally evaluated.Results Through the collection of medical history, the relevant examinations were completed, and liver biopsy was performed if necessary. The causes of 104 patients with abnormal liver function in early pregnancy included 27 cases of CHB (26.0%), 23 cases of NAFLD (22.1%), 20 cases of DILI (19.2%), 14 cases of ICP (13.5%) and 11 cases of AIH (10.6%). Compared with CHB, NAFLD and AIH, after treatment in DILI and ICP, ALT, AST were significantly higher (P<0.05). Compared with other groups, TBil increased significantly before ICP treatment (P<0.05). After treatment, there was no significant difference in ALT, AST and TBil among patients with various causes (P>0.05). NAFLD and DILI serum IgM and IgG were in the normal range; DILI ANA was positive in 8 cases (40.0%); The majority of AIH was IgG, and 9 cases (81.8%) were positive for AMA and/or AMA- M2. 104 patients were treated with liver protection and primary disease. After 2 weeks, liver function was rechecked, and 73 cases (70.2%) had normal liver function. 27 cases (26.0%) had improved liver function, and continued to be treated with liver protection. After 4-6 weeks of follow-up, they gradually returned to normal.Conclusion The causes of abnormal liver function in early pregnancy are complex and diverse, including infectious, metabolic, drug-induced, autoimmune and pregnancy-related special liver diseases. There are some differences in clinical manifestations, laboratory tests and pathological features among various etiologies.

Key words: Abnormal liver function, Early pregnancy, Liver puncture

ZHANG Jun, ZHANG Yang, ZHANG Jin-wei. Etiological analysis and clinical outcome evaluation of abnormal liver function in pregnant women in early pregnancy[J]. Chinese Hepatolgy, 2025, 30(3): 395-397.

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