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Idiopathic liver function test abnormality in pregnancy is associated with assisted reproduction techniques
Uri Kopylov1, Benjamin Avidan, Neofytos P Papageorgiou
1Department of Gastroenterology and Hepatology, Sheba Medical Center, Tel Hashomer, Israel. ukopylov@gmail.com
Objective:
To examine the prevalence, etiology, risk factors, and outcomes of liver abnormality in pregnancy, in a tertiary medical center, and to study the potential impact of artificial reproduction techniques (ART) on the incidence and the outcome of pregnancy-related liver abnormality.
Design:
A retrospective case-control study using an electronic database and patients' files.
Setting:
Tertiary referral center.
Patient(S):
Women in the third trimester of pregnancy who were hospitalized for delivery.
Intervention(S):
None.
Main Outcome Measure(S):
Development of significant elevation of alanine aminotransferase (ALT ≥ 100 IU/L). Secondary outcomes included development of maternal and fetal complications.
Result(S):
The upper limit of normal of ALT was ≥ 1.5 times and it occurred in 440 (1.6%) pregnancies; of those, 228 (0.8%) had ALT ≥ 100 IU/L. The etiology of significant liver test abnormality was idiopathic in 47% of patients. Compared with spontaneous pregnancies (295/23,793), ART was significantly associated with liver test abnormality (145/4, 520). The presence of ALT ≥ 100 IU/L in the third trimester was associated with higher rates of cesarean sections, prematurity, low birthweight, and fetal complications.
Conclusion(S):
A definite etiology was not determined in about half of pregnancy-associated liver test abnormality. The ART was significantly associated with liver test elevation. Significant liver test abnormality in the third trimester may have an impact on maternal and fetal/neonatal outcomes.
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