Outcome measurements
The outcomes of interest were divided into three domains, maternal complications, obstetric complications and fetal outcome or complications. Maternal complications included maternal mortality, hepatic decompensation, gastrointestinal bleeding or variceal bleeding. We defined maternal mortality as maternal death during pregnancy or within 42 days of termination of pregnancy. 15 We defined hepatic decompensation as the presence of jaundice, ascites or hepatic encephalopathy.
Obstetric complications included caesarean delivery, preterm delivery (birth <37 completed weeks gestation), postpartum hemorrhage (loss of >500 ml blood within 24 hours during or after delivery), miscarriage (pregnancy loss before 20th week), placental abruption and hypertensive disorders of pregnancy (including pregnancy induced hypertension (PIH; systolic blood pressure ≥90 mmHg or diastolic blood pressure ≥140 mmHg), preeclampsia (hypertension with proteinuria >300 mg per 24 hours) and the syndrome of hemolysis, elevated liver enzymes, and low platelet count (HELLP; diagnosed by laboratory abnormalities)).
Fetal complications included neonatal mortality (death within 28 days after pregnancy), admission at neonatal intensive care unit, intrauterine fetal demise (pregnancy loss at or after 20th week of gestation), congenital malformations and small for gestational age (SGA, birth weight less than 10th percentile for gestational age). Low birth weight (birth weight <2500 g) was used when SGA was not reported.