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


METHODS
A retrospective case-control study using an electronic database and patients' files.


METHODS
Tertiary referral center.


METHODS
Women in the third trimester of pregnancy who were hospitalized for delivery.


METHODS
None.


METHODS
Development of significant elevation of alanine aminotransferase (ALT ≥ 100 IU/L). Secondary outcomes included development of maternal and fetal complications.


RESULTS
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.


CONCLUSIONS
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.
Department of Gastroenterology and Hepatology, Sheba Medical Center, Tel Hashomer, Israel. ukopylov@gmail.com
Uri
U
Kopylov
Benjamin
B
Avidan
Neofytos P
NP
Papageorgiou
Lior H
LH
Katz
Eyal
E
Sivan
Eyal
E
Zimlichman
Haya
H
Hussein
Yaakov
Y
Maor
D000328:Adult; D015984:Causality; D005260:Female; D006801:Humans; D015994:Incidence; D007246:Infertility / Q000453:epidemiology* / Q000628:therapy*; D007557:Israel / Q000453:epidemiology; D008107:Liver Diseases / Q000175:diagnosis / Q000453:epidemiology*; D008111:Liver Function Tests; D008875:Middle Aged; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000453:epidemiology*; D027724:Reproductive Techniques, Assisted / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D013223:Statistics as Topic; D055815:Young Adult