Idiopathic liver function test abnormality in pregnancy is associated with assisted reproduction techniques

Capsule:
This retrospective study analyzed the risk factors for development of significant liver dysfunction in pregnancy and it’s specific etiologies. Assisted reproduction was significantly associated with liver test abnormalities.

Authors:
Uri Kopylov, M.D., Benjamin Avidan, Prof., Neofytos Papageorgiou, M.D., Lior Katz, M.D., Eyal Sivan, Prof., Eyal Zimlichman, M.D., Haya Hussein, M.D., Yaakov Maor, M.D.

Volume 99, Issue 2, Pages 377-381.e3, February 2013

Abstract:

Objectives:
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 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:
Development of significant elevation of alanine aminotransferase (ALT)  100 IU/L). Secondary outcomes included development of maternal and fetal complications.

Results:
ALT  1.5 x upper limit of normal 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%. Compared to spontaneous pregnancies (295/23,793), AR was significantly associated with liver test abnormality (145/4,520) (p < 0.0001). The presence of ALT  100 IU/L in the third trimester was associated with higher rates of: cesarean sections, prematurity, low birth weight, and fetal complications. Conclusions:
A definite etiology was not determined in about a half of pregnancyassociated liver test abnormality. AR 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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