Residual Liver Stiffness in the Postpartum Period in Women with Preeclampsia and Healthy Women: A Case-Control Study

Objective: We aimed to assess the presence of residual liver stiffness in preeclampsia 45 days after delivery. Study design: This was a longitudinal case-control study to assess the association between residual liver stiffness, measured 45 days postpartum, and hypertensive disorders of pregnancy. Cases were obstetric patients admitted with hypertension during pregnancy (preeclampsia with and without severe features, or HELLP syndrome) between June 2019 and September 2021. Controls were obstetric patients with similar ages, social status, gestational age (assessed by the first-trimester ultrasound), and geographical areas between the same period. A 2:1 case-control match was considered. Main outcome measures: We recorded blood pressure and laboratory tests during the hospital stay. We measured the residual liver stiffness in preeclampsia participants and controls 45 days after delivery. Results: We recruited 99 hypertensive patients and 46 control patients. The residual liver stiffness was higher in hypertensive cases than controls (4.6 [3.9-5.3] kPa vs. 4.0 [3.2-5.2] kPa; p = 0.039). Linear regression results showed that systolic and diastolic blood pressures and alanine aminotransferase positively correlated with liver stiffness values (p < 0.01). Conclusions: Preeclampsia and disease severity were associated with residual liver stiffness. Prospective studies should further evaluate the clinical implications of these findings.