title: Alanine aminotransferase as a predictor of adverse perinatal outcomes in women with intrahepatic cholestasis of pregnancy.
abstract: OBJECTIVE
  To evaluate the associations between adverse perinatal outcomes and serum transaminase levels at the time of diagnosis in patients with intrahepatic cholestasis of pregnancy.
  
  
  METHODS
  We performed a retrospective analysis of patients hospitalized for evaluation of intrahepatic cholestasis of pregnancy from January 2013 to June 2014 in a tertiary center. Seventy-one patients were divided into two groups according to the presence (Group I) or absence of adverse perinatal outcomes (Group II).
  
  
  RESULTS
  The mean aminotransferase levels and conjugated bilirubin levels at the time of diagnosis were significantly higher in Group I than in Group II. Receiver operating characteristic curve analysis revealed that the alanine aminotransferase level could predict adverse perinatal outcomes with 76.47% sensitivity and 78.38% specificity, and the cut-off value was 95 IU/L. Among patients with intrahepatic cholestasis of pregnancy, those with adverse perinatal outcomes were significantly older, had an earlier diagnosis, and had higher alanine aminotransferase levels. Using the 95-IU/L cut-off value, patients with intrahepatic cholestasis of pregnancy had a 3.54-fold increased risk for adverse perinatal outcomes.
  
  
  CONCLUSIONS
  Patients with intrahepatic cholestasis of pregnancy and high alanineaminotransferase levels should be followed up for possible adverse perinatal outcomes.
authors.affiliation: Ali Ekiz, Department of Maternal-Fetal Medicine Unit, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Ekiz
authors.affiliation: Basak Kaya, Department of Maternal-Fetal Medicine Unit, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey.
authors.forename: Basak
authors.initials: B
authors.lastname: Kaya
authors.affiliation: Muhittin Eftal Avci, Department of Maternal-Fetal Medicine Unit, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey.
authors.forename: Muhittin Eftal
authors.initials: ME
authors.lastname: Avci
authors.affiliation: Ibrahim Polat, Department of Maternal-Fetal Medicine Unit, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Polat
authors.affiliation: Selin Dikmen, Department of Obstetrics and Gynecology, Gokhan Yildirim, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey.
authors.forename: Selin
authors.initials: S
authors.lastname: Dikmen
authors.affiliation: Department of Maternal-Fetal Medicine Unit, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey.
authors.forename: Gokhan
authors.initials: G
authors.lastname: Yildirim
keywords: Adverse perinatal outcome; Alanine aminotransferase; Intrahepatic cholestasis; Pregnancy