Non-Alcoholic Fatty Liver Disease in Pregnancy with Estimation of Feto-Maternal Outcome in a Tertiary Hospital in Bangladesh

The Journal of Ad-din Women's Medical College Pub Date : 2023-07-09 DOI:10.3329/jawmc.v10i1.67452

Md. Akmat Ali, Zakiul Hassan, F. Yeasmin, Khadija Begum, Ahm Khairul Imam, Mohammad Moin Shohid, Nila Akter Keya, K. S. Anwar

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Abstract

Background: Non-alcoholic Fatty Liver Disease (NAFLD) is a growing public health concern globally. NAFLD has been linked with adverse pregnancy outcome. The prevalence of NAFLD among women in childbearing age is 10%. During pregnancy both physiologic and pathologic fluctuation in estrogen as well as rapid weight gain plays an important role in the development of NAFLD in mother and infant. Objective: To find out clinical and laboratory profile and pregnancy outcome of patients with fatty liver disease. Methods: We conducted this observational study between January through December 2017 in (pro-women, pro-poor) Ad-din Women Medical College Hospital in Maghbazar, Dhaka, Bangladesh. We enrolled 103 pregnant women who signed the consent (verbal) to participate in the study. Demographic and clinical information was collected using a pre-tested questionnaire. Results: Mean age of the patients was 27 years. During first trimester 18 patients were enrolled, 32 in second and 53 in third trimesters. Of 103, 3 (2.91%) patients had known history of fatty liver disease, 11 (10.68%) had hypertension, 11 (10.68%) had Gestational Diabetes Mellitus (GDM) but none had previous history of Diabetes Mellitus (DM). Among all, 8 (7.76%) patients had previous pregnancy related complications and 32 (31%) had foetal complications including still birth, abortion, neonatal death and Intrauterine Device (IUD). Beside, 92 (89.3%) had grade 1, 10 (9.7%) had grade 2 and one (0.97%) patient had grade 3 fatty liver. 35 (32.4%) patients had high Fasting Blood Sugar level and 26 (24.1%) patients had positive Oral Glucose Tolerance Test (OGTT). And, 31% patients had a high cholesterol level, none had abnormal HDL, 5.8% had high LDL and 78.6% had high TG. USG identified 3 patients with abnormal fetal profile and only 2 patients had adverse pregnancy outcome: one IUD and one abortion. Conclusions: Non-alcoholic fatty liver Disease increases the risk of maternal and fetal complications. Pregnant women should regularly screen for fatty liver disease for early detection and intervention. The Journal of Ad-din Women's Medical College; Vol. 10 (1), Jan 2022; p 33-37

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妊娠期非酒精性脂肪性肝病与孟加拉国一家三级医院胎儿-母体结局的估计

背景:非酒精性脂肪性肝病(NAFLD)是全球日益关注的公共卫生问题。NAFLD与不良妊娠结局有关。育龄妇女NAFLD患病率为10%。妊娠期雌激素的生理性和病理性波动以及体重的快速增加在母婴NAFLD的发展中起着重要作用。目的:了解脂肪肝患者的临床、实验室情况及妊娠结局。方法:我们于2017年1月至12月在孟加拉国达卡Maghbazar的Ad-din女子医学院医院(亲妇女，亲穷人)进行了这项观察性研究。我们招募了103名孕妇，她们签署了同意书(口头)参与这项研究。使用预先测试的问卷收集人口统计和临床信息。结果:患者平均年龄27岁。18名患者在妊娠早期入组，32名在妊娠中期入组，53名在妊娠晚期入组。103例患者中有脂肪肝病史3例(2.91%)，高血压11例(10.68%)，妊娠期糖尿病11例(10.68%)，无糖尿病史。其中有妊娠相关并发症8例(7.76%)，有死产、流产、新生儿死亡、宫内节育器(IUD)等胎儿并发症32例(31%)。1级92例(89.3%)，2级10例(9.7%)，3级1例(0.97%)。35例(32.4%)患者空腹血糖水平较高，26例(24.1%)患者口服糖耐量试验(OGTT)阳性。31%的患者有高胆固醇水平，没有异常HDL, 5.8%的患者有高LDL, 78.6%的患者有高TG。USG发现3例胎儿外形异常，仅有2例出现不良妊娠结局:1例宫内节育器和1例流产。结论:非酒精性脂肪性肝病增加母体和胎儿并发症的风险。孕妇应定期筛查脂肪肝，以便及早发现和干预。Ad-din女子医学院学报;Vol. 10 (1)， Jan 2022;p 33-37

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The Journal of Ad-din Women's Medical College

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