title: Prediction of preeclampsia: liver function tests during the first 20 gestational weeks.
abstract: OBJECTIVE
  To examine whether plasma levels of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) during the first 20 weeks of pregnancy can predict preeclampsia in the second half of pregnancy.
  
  
  METHODS
  The study population included 150,10 registered births. Receiver operating characteristic (ROC) curve analysis was used to describe the relationship between different values of AST and ALT during the first 20 weeks of pregnancy in the prediction of preeclampsia.
  
  
  RESULTS
  Using ROC curve analyses, elevated ALT levels were significantly associated with both mild preeclampsia (p < 0.001) and severe preeclampsia (p = 0.032). However, an ALT level of 50 IU/L had a sensitivity of only 3.3% (despite a specificity of 97%) in the prediction of severe preeclampsia. While no significant association was noted between AST levels and mild preeclampsia (p = 0.669), elevated levels of AST during this period were significantly associated with severe preeclampsia (p = 0.027). However, AST of 50I U/L had a sensitivity of only 2.0% (despite a specificity of 98%) in the prediction of severe preeclampsia.
  
  
  CONCLUSIONS
  Higher levels of the liver enzymes AST and ALT during the first 20 weeks of pregnancy are associated with higher risk for the development of severe preeclampsia in the second half of the pregnancy. Nevertheless, there is no clinical cutoff value that can be practically used for the prediction of preeclampsia.
authors.affiliation: Department of Obstetrics and Gynecology, Hillel Yaffe Medical Center, Hadera, Israel. eladmei@yahoo.com
authors.forename: Elad
authors.initials: E
authors.lastname: Mei-Dan
authors.forename: Arnon
authors.initials: A
authors.lastname: Wiznitzer
authors.forename: Ruslan
authors.initials: R
authors.lastname: Sergienko
authors.forename: Mordechai
authors.initials: M
authors.lastname: Hallak
authors.forename: Eyal
authors.initials: E
authors.lastname: Sheiner
mesh_terms: D015331:Cohort Studies; D005260:Female; D005865:Gestational Age; D006801:Humans; D008099:Liver / Q000201:enzymology / Q000503:physiopathology*; D008111:Liver Function Tests; D011225:Pre-Eclampsia / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D011247:Pregnancy; D011261:Pregnancy Trimester, First / Q000097:blood / Q000378:metabolism / Q000502:physiology; D011262:Pregnancy Trimester, Second / Q000097:blood / Q000378:metabolism / Q000502:physiology; D015995:Prevalence; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index