Association of Deranged Liver Enzymes in Pregnancy with Fetal Outcomes in the Post-COVID Era

Abstract

Objective: To assess the association of feto-maternal outcomes of patients with deranged Liver Function Tests having a history of COVID-19 infection. Study Design: Cross-sectional study. Place and Duration of Study: Department of Gynaecology and Obstetrics, Combined Military Hospital, Rawalpindi and Quetta Pakistan, from Aug 22 to April 2023. Methodology: A sample of one hundred and forty-six pregnant patients fulfilling the inclusion criteria were enrolled using a consecutive sampling technique. Various investigations were performed to confirm pregnancy-associated liver disease and rule out other causes of hepatitis. Patients with known diabetes, liver disease, renal disease and cancer before the current pregnancy were excluded. Patients were followed up until delivery, and their fetal and maternal outcomes were assessed. Results: Among 2409 pregnant patients presenting during the study time, 146(6.06%) patients presented with deranged Liver Function Tests. Fetal adverse outcome (Meconium staining of liquor or Intrauterine Device was observed in 55/146(37.7%) cases. Of the 146 participants, four deaths occurred, resulting in a death rate of 4/146(2.74%). Significant differences were observed in haemoglobin levels and platelet counts between the surviving and deceased groups. Significant associations were found between survival outcomes and history of COVID-19 infection, COVID-19 in current pregnancy, and hypertension. However, none of the variables emerged as significant predictors of survival in the regression analysis. Conclusion: Lower haemoglobin levels, lower platelet counts, history of COVID-19 infection, COVID-19 in current pregnancy, and hypertension were associated with poorer outcomes in pregnant patients with deranged Liver Function Tests.

Keywords

• COVID-19 infection, Cholestasis of pregnancy, Liver function tests, Pregnancy.