Can alanine aminotransferase measured in early pregnancy predict macrosomia?

Bulut, Ayca Nazli; Ceyhan, Venhar; Dolanbay, Mehmet

doi:10.1080/01443615.2022.2039905

Cited by 2 publications

(1 citation statement)

References 18 publications

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“…However, some studies have shown that the prevalence of elevated LFTs is up to 5–13% [ 5 , 77 , 79 , 85 ], which is much higher than the canonic 3% prevalence of pregnancy-related liver disease [ 86 ], suggesting that there may be more to it than what was previously thought. Most studies have evaluated LFTs during the first trimester [ 77 , 85 , 87 , 88 ], showing that higher ALT levels are associated with an increased risk of future gestational diabetes [ 77 , 87 , 88 ], large-for-gestational-age babies [ 85 , 89 , 90 ], and pre-eclampsia [ 77 , 78 , 79 ]. In other studies, altered LFTs were investigated in the third trimester (or at delivery), with a reported prevalence of 11–13% [ 5 ].…”

Section: Other Causes Of Elevated Liver Enzymes: Hypotheses and Specu...mentioning

confidence: 99%

Diagnostic Approach to Elevated Liver Function Tests during Pregnancy: A Pragmatic Narrative Review

Dajti,

Bruni,

Barbara

et al. 2023

JPM

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Liver disease is not uncommon during pregnancy and is associated with increased maternal and fetal/neonatal morbidity and mortality. Physiological changes during pregnancy, including a hyperestrogenic state, increase in circulating plasma volume and/or reduction in splanchnic vascular resistance, and hemostatic imbalance, may mimic or worsen liver disease. For the clinician, it is important to distinguish among the first presentation or exacerbation of chronic liver disease, acute liver disease non-specific to pregnancy, and pregnancy-specific liver disease. This last group classically includes conditions such as hyperemesis gravidarum, intrahepatic cholestasis of pregnancy, liver disorders associated with the pre-eclampsia spectrum, and an acute fatty liver of pregnancy. All of these disorders often share pathophysiological mechanisms, symptoms, and laboratory findings (such as elevated liver enzymes), but a prompt and correct diagnosis is fundamental to guide obstetric conduct, reduce morbidity and mortality, and inform upon the risk of recurrence or development of other chronic diseases later on in life. Finally, the cause of elevated liver enzymes during pregnancy is unclear in up to 30–40% of the cases, and yet, little is known on the causes and mechanisms underlying these alterations, or whether these findings are associated with worse maternal/fetal outcomes. In this narrative review, we aimed to summarize pragmatically the diagnostic work-up and the management of subjects with elevated liver enzymes during pregnancy.

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Section: Other Causes Of Elevated Liver Enzymes: Hypotheses and Specu...mentioning

confidence: 99%

Diagnostic Approach to Elevated Liver Function Tests during Pregnancy: A Pragmatic Narrative Review

Dajti,

Bruni,

Barbara

et al. 2023

JPM

View full text Add to dashboard Cite

show abstract

Comprehensive analysis of macrosomia: exploring the association between first-trimester alanine aminotransferase and uric acid measurements in pregnant women

Arslanca,

Caglar

2023

Journal of Perinatal Medicine

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Objectives Investigating the relationship between liver enzymes, uric acid (UA), and macrosomia will benefit physicians in the early detection of complications that may emerge during/after pregnancy. The study analyzed liver enzyme activity and UA levels in first-trimester pregnant for the risk of macrosomia. Methods This retrospective cross-sectional research analyzed the data of pregnant women who gave birth between Jan 2021–2023. All data were extracted from medical records, and UA and AST-ALT were examined in all the participants. Results Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels were higher in the macrosomia (p<0.05). Similarly, UA levels were higher in the macrosomia (p<0.001). There was a moderate positive correlation between ALT and birth weight (r=0.168, p<0.01), while we found a strong positive correlation between UA and birth weight (r=0.355, p<0.01). In the ROC (receiver operating characteristic), Area Under the Curve (AUC) for ALT and UA was significant (p<0.0001) but not for AST (p=0.157). UA showed a predictive value for macrosomia with 68.1 % sensitivity and 63.8 % specificity at a 3.15 cut-off (AUC:0.689; p:0.0001; CI:0.644–0.725). Conclusions These results indicate that ALT and UA may be potentially important in determining the risk of macrosomia. The UA had a more potent marker for macrosomia than ALT. The occurrence of macrosomia might be more closely related to the mother’s metabolic syndrome rather than NAFLD.

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Can alanine aminotransferase measured in early pregnancy predict macrosomia?

Cited by 2 publications

References 18 publications

Diagnostic Approach to Elevated Liver Function Tests during Pregnancy: A Pragmatic Narrative Review

Diagnostic Approach to Elevated Liver Function Tests during Pregnancy: A Pragmatic Narrative Review

Comprehensive analysis of macrosomia: exploring the association between first-trimester alanine aminotransferase and uric acid measurements in pregnant women

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