Elevated Liver Function Tests as Predictors of Severe Maternal Outcomes in Women with Preeclampsia

Background: Preeclampsia is a hypertensive disorder of pregnancy that ultimately led to high mortality and morbidity due to its complication HELP (Hemolysis, Elevated Liver Enzymes, and Low Platelet count), syndrome, and its association with elevated liver function tests. The main objective of this study is to investigate the association between elevated alanine aminotransferase (ALT), aspartate aminotransferase (AST), and alkaline phosphatase (ALP) and severe maternal outcomes in women diagnosed with preeclampsia. Methods: A cross-sectional study was conducted using convenience sampling at the Department of Obstetrics and Gynecology, Central Park Teaching Hospital Lahore Pakistan from April 18, 2024, to August 5, 2024. Group A with severe maternal outcome group eclampsia, HELLP, and group B without severe outcome. Liver function tests (AST, ALT, and ALP) were measured upon diagnosis. Severe maternal outcomes were statistically analyzed using SPSS version 26 applying a paired t-test. Results: Among 300 women diagnosed with preeclampsia 90(30%) had increased LFTs and severe maternal outcomes were measured in 45 (50%) women with increased LFTs as compared to 30 (14.3%) women with normal LFTs(p=0.001). logistic regression analysis also showed that increased ALT (OR 3.7, 95%CI 2.01-7.02, p<0.001) and AST (OR 4.4, 95%CI 2.4-8.02, P<0.001) were significant predictors of severe maternal outcome while ALP was not associated with severe outcomes (OR 1.2, 95%CI 0.8-2.4, p=0.41). Conclusion: This study provides new insight into the prognostic values of LFTs, which could increase their prognostic value and improve clinical decision-making and maternal care in preeclampsia.