{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T17:37:11Z","timestamp":1793295431185,"version":"4.5.0"},"reference-count":24,"publisher":"S. Karger AG","license":[{"start":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T00:00:00Z","timestamp":1791763200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"},{"start":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T00:00:00Z","timestamp":1791763200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gynecol Obstet Invest"],"abstract":"<jats:p>Objectives: Acute fatty liver of pregnancy (AFLP) is a life-threatening condition associated with high neonatal morbidity. This study aimed to conduct an exploratory risk-stratification analysis using diagnosis-day laboratory indicators to assess severe adverse neonatal outcomes (SANOs). Methods: In this single-center retrospective cohort (2004\u20132021), 18 pregnancies with AFLP confirmed by Swansea criteria were analyzed. Firth-penalized logistic regression assessed associations between the first laboratory values on the diagnosis day and SANO (intrauterine death\/severe asphyxia). Minimal two-variable models combining prothrombin time (PT) with total bilirubin or peak transaminase were evaluated. Model performance was summarized using the area under the receiver operating characteristic curve (AUC), leave-one-out cross-validation (LOOCV), and descriptive temporal sensitivity analysis. Results: The incidence of AFLP was 0.71 per 10,000 pregnancies. At the pregnancy level, SANO occurred in 4 of 18 pregnancies (22.2%). Diagnosis-day coagulopathy, especially prolonged PT, was the most prominent associated marker. The PT + Peak transaminase model yielded an apparent AUC of 0.982 and a LOOCV AUC of 0.964, but these estimates require cautious interpretation because only 4 SANO events were available. The descriptive temporal sensitivity analysis showed 2 SANO events in both 2004\u20132012 and 2013\u20132021. Conclusions: Coagulation dysfunction at diagnosis may serve as an exploratory indicator of neonatal risk in AFLP. The proposed PT-centered framework should be interpreted as a hypothesis-generating risk-stratification signal that requires external validation before clinical use.<\/jats:p>","DOI":"10.1159\/goi\/aczag013","type":"journal-article","created":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T11:39:03Z","timestamp":1791027543000},"page":"1-1","source":"Crossref","is-referenced-by-count":0,"title":["Diagnosis-Day Prothrombin Time and Transaminase as Exploratory Risk-Stratification Indicators for Severe Neonatal Outcomes in Acute Fatty Liver of Pregnancy"],"prefix":"10.1159","author":[{"given":"Dong","family":"Xu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peiyue","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lihua","family":"Shao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Baihui","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2026,10,12]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2013.07.006"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2015.08.022"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.3390\/ijms23073595"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1258\/om.2011.100071"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-020-2787-4"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-021-04095-8"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-019-05259-w"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.3109\/14767058.2010.531325"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-020-02980-2"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2020.06.052"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.15137"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1177\/1753495X18759353"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2021.719906"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1186\/s13256-025-05362-4"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2017.54"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1097\/GRF.0000000000000494"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1186\/s12887-025-05481-3"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2023-077943"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.94576"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1111\/jog.16230"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1136\/gut.51.6.876"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1186\/cc11454"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.14955"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1002\/hep.32039"}],"container-title":["Gynecologic and Obstetric Investigation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/article-pdf\/doi\/10.1159\/goi\/aczag013","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T17:01:28Z","timestamp":1793293288000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/goi\/aczag013"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,12]]},"references-count":24,"URL":"https:\/\/doi.org\/10.1159\/goi\/aczag013","archive":["Portico"],"relation":{"is-supplemented-by":[{"id-type":"doi","id":"10.6084\/m9.figshare.34308939","asserted-by":"subject"}]},"ISSN":["0378-7346","1423-002X"],"issn-type":[{"value":"0378-7346","type":"print"},{"value":"1423-002X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,12]]}}}