A retrospective analysis of coagulation function indicators in acute fatty liver of pregnancy.

Background: Acute Fatty Liver of Pregnancy (AFLP) is a rare but life-threatening obstetric emergency. Coagulation dysfunction is a core pathophysiological feature and a key risk factor for adverse events. This study retrospectively analyzed 92 AFLP patients to evaluate the association between coagulation indicators and multiple adverse outcomes, and obtain primary indicator that can predict the severity of disease. Methods: This retrospective cohort study included 92 AFLP patients treated at our hospital from 2017 to 2023. We collected clinical manifestations, laboratory data, and composite adverse outcomes including ICU admission, maternal complications. Logistic regression with variance inflation factor (VIF) diagnostics was used to analyze independent correlates of adverse outcomes. Receiver operating characteristic (ROC) analysis was performed for single indicators. Results: INR (AUC 0.837) and PT (AUC 0.837) showed the strongest individual predictive performance for composite adverse outcomes, these two indicators are the mostsensitive in predicting severity of AFLP. The VIF value of PT is greater than 10, indicating severe multicollinearity. The VIF value of INR was less than 5, and was independently associated with higher rates of MODS, DIC, postpartum hemorrhage. Conclusion: Coagulation function indicators are strongly associated with adverse clinical events in AFLP. INR provides improved risk stratification performance over other markers and may support clinical decision-making. This preliminary indicator requires external validation before routine clinical use.