The Effect Of Liver Function On The Outcome Of Delivery In Late Pregnancy

Objective:To explore the effect of liver function on the outcome of delivery in late pregnancy by retrospective cohort study.Method:From January 2018 to April 2019,a total of 3501 pre-gnant women were hospitalized in our hospital,and clinical data and biochemical indicators of liver function were collected.Single birth pregnant women who were hospitalized in our hospital and had a g e-stational age≥28 weeks and were 20～45 years old were include d,patients with fetal death,drug-induced liver damage and no index o f liver function in the third trimester were excluded.A total of 2054subjects were enrolled in the study.The subjects were divided into t-hree groups:normal group（1344）,complication group（667）and h ea-ptitis group（43）.According to gestational weeks for detection of l iv-er function,the normal group was divided into 28～31⁺⁶weeks,32～36⁺⁶weeks and 37～41⁺⁶weeks.Hepatitis group:Patients with hep atit-is B and hepatitis C before this pregnancy;Complications group:this pregnancy has any of the following diseases,pregnancy hyperte nsion,preeclampsia,chronichypertension with pregnancy,chronic hyperte nsion with preeclampsia,gestational diabetes,fatty liver,intrahepatic c holes-tasis of pregnancy,hypothyroidism of pregnancy,diabetes mellit us wi-th pregnancy,systemic lupus erythematosus,antiphospholipid an tibody syndrome,hypothyroidism pregnancy,severe anemia;No diseas e in th-e above two groups is normal group.The biochemical indexe s of liv-er function include albumin（ALB）,alanine aminotransferase（A LT）,aspa-rtate aminotransferase（AST）,AST/ALT,Gamma-glutamyl tran speptidas-e（GGT）,alkaline phosphatase（ALP）,cholinesterase（CE）,adenos ine dea-minase（ADA）,fucosidase（AFU）,prealbumin（PA）.According to t he refer-ence threshold of 95%or 5%in one side of normal group（1344）,the index of liver function（2054）was divided into normal liver fu-nction group（control group）and abnormal liver function gr oup（case group）,and multivariate logistic regression was used to ana lyze the effect of abnormal liver function on delivery outcome.Result:The reference ranges of ALB,ALT,AST,GGT,ALP,CE,ADA,AFU,PA in biochemical indexes of late pregnancy were different from those of nonpregnant healthy people.ALB,ALT,AST,GGT,CE,ADA decreased,ALP,AFU,PA increased.The proportion of abnormal ALP and AFU liver function indexes increased in the patients with complications,and that of AST,ALP and AFU liver function indexes increased in the patients with hepatitis.Multivariate logistic regression analysis indicated that abnormal liver function was a risk factor for adverse delivery outcome:PA is an independent risk factor for the transfer of maternal to ICU;ALB,ALT,AST,GGT and PA are the independent risk factors of premature delivery;AST is the independent risk factors of low birth weight infants;ALB,ALT,AST,GGT,ADA and PA are the independent risk factors of neonatal transfer to NICU;AFU is an independent protective factor for newborn transferred to NICU;AST,GGT and ALB are the independent risk factors of neonatal Apgar<7 points.Conclusion:The reference value of biochemical indexes of liver function in late pregnancy is different from that in nonpregnancy.The abnormal indexes of ALB,ALT,AST,GGT,ADA,AFU and PA were related to the poor delivery outcome.