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

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.


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



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.


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


Tertiary referral center.


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



Main outcome:

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


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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