Evidence map›Paper›PMID 41727930›Full record

ReviewO&G open2026

Acute Fatty Liver of Pregnancy and Fetal Fatty Acid Oxidation Disorders: A Systematic Review.

Dante Varotsis, Sarah Araji, Rebecca Horgan, Jennifer E Powel, Rodney McLaren, Brian Kirmse, Mona M Makhamreh, Huda B Al-Kouatly

Abstract readReview
In one paragraph

Review in O&G open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Dante VarotsisDepartment of Obstetrics and Gynecology and Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania; Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine and Department of Pediatrics, Division of Genetics, University of Mississippi Medical Center, Jackson, Mississippi; Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Eastern Virginia Medical School, Norfolk, Virginia; Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Hackensack Meridian Jersey Shore University Medical Center, Neptune, New Jersey; and Department of Obstetrics and Gynecology, Maimonides Medical Center, Brooklyn, New York.
Sarah ArajiDepartment of Obstetrics and Gynecology and Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania; Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine and Department of Pediatrics, Division of Genetics, University of Mississippi Medical Center, Jackson, Mississippi; Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Eastern Virginia Medical School, Norfolk, Virginia; Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Hackensack Meridian Jersey Shore University Medical Center, Neptune, New Jersey; and Department of Obstetrics and Gynecology, Maimonides Medical Center, Brooklyn, New York.
Rebecca HorganDepartment of Obstetrics and Gynecology and Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania; Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine and Department of Pediatrics, Division of Genetics, University of Mississippi Medical Center, Jackson, Mississippi; Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Eastern Virginia Medical School, Norfolk, Virginia; Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Hackensack Meridian Jersey Shore University Medical Center, Neptune, New Jersey; and Department of Obstetrics and Gynecology, Maimonides Medical Center, Brooklyn, New York.
Jennifer E PowelDepartment of Obstetrics and Gynecology and Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania; Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine and Department of Pediatrics, Division of Genetics, University of Mississippi Medical Center, Jackson, Mississippi; Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Eastern Virginia Medical School, Norfolk, Virginia; Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Hackensack Meridian Jersey Shore University Medical Center, Neptune, New Jersey; and Department of Obstetrics and Gynecology, Maimonides Medical Center, Brooklyn, New York.
Rodney McLarenDepartment of Obstetrics and Gynecology and Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania; Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine and Department of Pediatrics, Division of Genetics, University of Mississippi Medical Center, Jackson, Mississippi; Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Eastern Virginia Medical School, Norfolk, Virginia; Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Hackensack Meridian Jersey Shore University Medical Center, Neptune, New Jersey; and Department of Obstetrics and Gynecology, Maimonides Medical Center, Brooklyn, New York.
Brian KirmseDepartment of Obstetrics and Gynecology and Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania; Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine and Department of Pediatrics, Division of Genetics, University of Mississippi Medical Center, Jackson, Mississippi; Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Eastern Virginia Medical School, Norfolk, Virginia; Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Hackensack Meridian Jersey Shore University Medical Center, Neptune, New Jersey; and Department of Obstetrics and Gynecology, Maimonides Medical Center, Brooklyn, New York.
Mona M MakhamrehDepartment of Obstetrics and Gynecology and Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania; Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine and Department of Pediatrics, Division of Genetics, University of Mississippi Medical Center, Jackson, Mississippi; Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Eastern Virginia Medical School, Norfolk, Virginia; Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Hackensack Meridian Jersey Shore University Medical Center, Neptune, New Jersey; and Department of Obstetrics and Gynecology, Maimonides Medical Center, Brooklyn, New York.
Huda B Al-KouatlyDepartment of Obstetrics and Gynecology and Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania; Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine and Department of Pediatrics, Division of Genetics, University of Mississippi Medical Center, Jackson, Mississippi; Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Eastern Virginia Medical School, Norfolk, Virginia; Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Hackensack Meridian Jersey Shore University Medical Center, Neptune, New Jersey; and Department of Obstetrics and Gynecology, Maimonides Medical Center, Brooklyn, New York.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo evaluate the association between maternal acute fatty liver of pregnancy (AFLP) and fetal fatty acid oxidation (FAO) disorders and to define the clinical and genetic characteristics of mothers with AFLP and their fetuses affected by FAO disorders, we performed a systematic literature review of all reported cases of AFLP that underwent genetic testing for FAO disorders. DATA SOURCES: We searched PubMed, Ovid MEDLINE, Cochrane Library, CINAHL (EBSCO), Scopus, and ClinicalTrials.gov. Terms included were related to AFLP and FAO testing. METHODS OF STUDY SELECTION: We conducted a systematic literature review from inception through May 18, 2025, to evaluate the relationship between AFLP and fetal FAO disorders. Studies were eligible for inclusion if they evaluated the relationship between AFLP and fetal FAO disorders and provided both detailed pregnancy characteristics for AFLP and the workup of maternal and/or fetal FAO disorder. TABULATION INTEGRATION AND

resultsTwenty-seven studies with 77 AFLP cases that underwent genetic or biochemical testing for maternal or fetal FAO disorders were included. Of these 77 pregnancies, 27 (35.1%) were associated with confirmed fetal FAO disorders. The 27 neonates with FAO disorders included 22 fetuses (81.5%) with LCHAD deficiency, three (11.1%) with medium-chain acyl-CoA dehydrogenase deficiency, one (3.7%) with short-chain acyl-CoA dehydrogenase deficiency, and one (3.7%) with carnitine palmitoyl transferase-I deficiency. Stillbirth and infant mortality was reported in 14 of 22 cases (63.6%) with LCHAD deficiency, and there were no recorded fetal or neonatal deaths with other FAO disorders or those with negative genetic testing. One maternal death was reported in a pregnancy with negative genetic testing for FAO disorders and one patient in a coma at the time of publication with an LCHAD-deficient pregnancy. Presentation of AFLP with gastrointestinal manifestations occurred in 87.8% of patients.

conclusionAcute fatty liver of pregnancy is associated with fetal FAO disorders in about a third of cases, with the most common FAO disorder being LCHAD deficiency. Both AFLP and LCHAD deficiency are associated with high morbidity and mortality in mothers and neonates. Evaluation for fetal and maternal LCHAD deficiency should be part of the diagnostic evaluation in AFLP. SYSTEMATIC REVIEW REGISTRATION: PROSPERO, CRD42021247166.

Identifiers

PMID41727930
PMCPMC12922938

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.