Perinatal Outcomes in Pregnant Women with Abnormal Liver Function Tests

Abstract

Background: Despite being very uncommon, abnormal liver function during pregnancy is linked to poor maternal and perinatal outcomes, such as low birth weight, preterm birth, fetal distress, and neonatal mortality. These issues are particularly common in developing nations like Pakistan, where there may be limited access to prompt, specialist medical care. The purpose of this study was to determine the effects of prompt diagnosis and treatment on the perinatal outcomes of pregnant women with abnormal liver function tests (LFTs). Methods: A descriptive study was conducted at Jinnah Postgraduate Medical Centre (JPMC), Karachi, over six months in the duration from 2^nd March, 2025 to 15^th June, 2025. A total of 135 pregnant women with abnormal LFTs were enrolled using consecutive sampling. Abnormal liver function was defined by specific thresholds for total bilirubin, ALT, AST, ALP, and GGT levels. Key perinatal outcomes, including preterm birth, low birth weight, poor Apgar scores, fetal distress, NICU admission, and neonatal death, were documented. Data were analyzed using SPSS version 24, with stratification and chi-square tests performed to identify significant associations. Results: The study found that 20.7% of participants experienced preterm birth, while 24.4% of neonates had low birth weight. Poor Apgar scores (<7 at 5 minutes) were recorded in 16.3% of cases, and fetal distress occurred in 18.5% of pregnancies. NICU admission was required in 22.2% of neonates, and the neonatal death rate was 4.4%. Elevated ALT and AST levels were significantly associated with preterm birth and NICU admission (p = 0.02), while total bilirubin levels were linked to poor Apgar scores (p = 0.03). The findings indicate that early diagnosis and interventions contributed to improved neonatal outcomes, as reflected by lower rates of severe complications compared to previous studies. Conclusion: Abnormal liver function during pregnancy is associated with increased risks of adverse perinatal outcomes. However, timely management and regular monitoring can reduce these risks and improve maternal and neonatal health. The study underscores the importance of integrating liver function screening into routine antenatal care, especially in high-risk populations. These findings advocate for enhanced healthcare protocols to ensure early diagnosis and intervention in pregnancies complicated by liver dysfunction.