ArticleFrontiers in cardiovascular medicine2022
High-normal liver enzyme levels in early pregnancy predispose the risk of gestational hypertension and preeclampsia: A prospective cohort study.
Article in Frontiers in cardiovascular medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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11 citing papers in PubMed, 17 citations in OpenAlex.
- Elevated gamma-glutamyl transferase levels in early pregnancy increase pregnant women's risk of gestational hypertension and preeclampsia.Journal of global health · 2026Article
- Integrated molecular and histological profiling of preeclampsia suggests angiogenic dysregulation associated with maternal and fetal outcomes.Scientific reports · 2026Article
- Pre-Eclampsia-Induced Maternal Liver Dysfunction: Systematic Review, Meta-Analysis and Meta-Regression of Observation Studies.Life (Basel, Switzerland) · 2026Review
- Elevated maternal serum aminotransferase in early pregnancy associated with early-onset preeclampsia: A cohort study of 116,967 pregnancies in Shanghai, China.BMC pregnancy and childbirth · 2025Article
- Early prediction of preeclampsia from clinical, multi-omics and laboratory data using random forest model.BMC pregnancy and childbirth · 2025Article
- Predicting preeclampsia in early pregnancy using clinical and laboratory data via machine learning model.BMC medical informatics and decision making · 2025Article
- Investigating the prevalence and associated factors of elevated liver enzymes and dyslipidemia during pregnancy.Scientific reports · 2025Article
- Predictivity of Hepatic Steatosis Index for Gestational Hypertension and Preeclampsia: a Prospective Cohort Study.International journal of medical sciences · 2025Article
- A prediction model of superimposed preeclampsia in women with chronic hypertension.Frontiers in cardiovascular medicine · 2025Article
- Associations of maternal liver biomarkers in the first trimester with the risk of hypertensive disorders of pregnancy.Hypertension research : official journal of the Japanese Society of Hypertension · 2024Article
- Diagnostic Approach to Elevated Liver Function Tests during Pregnancy: A Pragmatic Narrative Review.Journal of personalized medicine · 2023Article
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Authors and funding
12 authors at 2 institutions in 1 country.
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Abstract
Background: Gestational hypertension (GH) and preeclampsia (PE) are severe adverse gestational complications. Previous studies supported potential link between elevated liver enzyme levels and GH and PE. However, given the transient physiological reduction of liver enzyme levels in pregnancy, little is known whether the associations of the high-normal liver enzyme levels in early pregnancy with GH and PE exist in pregnant women. Methods: Pregnant women in this study came from a sub-cohort of Shanghai Preconception Cohort, who were with four liver enzyme levels examined at 9-13 gestational weeks and without established liver diseases, hypertension and preeclampsia. After exclusion of pregnant women with clinically-abnormal liver enzyme levels in the current pregnancy, associations of liver enzyme levels, including alkaline phosphatase (ALP), alanine transaminase (ALT), aspartate aminotransferase (AST) and gamma-glutamyl transpeptidase (GGT), with GH and PE status were assessed by multivariable log-binomial regression. Population attributable fraction was measured to estimate the fractions of GH and PE that were attributable to the high-normal liver enzyme levels. Results: Among 5,685 pregnant women 160 (2.8%) and 244 (4.3%) developed GH and PE, respectively. After adjustment for potential covariates, higher ALP, ALT and GGT levels were significantly associated with the risk of GH (adjusted risk ratio (aRR):1.21 [95% confidence interval, 1.05-1.38]; 1.21 [1.05-1.38]; and 1.23 [1.09-1.39]), as well as the risk of PE(1.21 [1.13-1.29]; 1.15 [1.03-1.28]; 1.28 [1.16-1.41]), respectively. The cumulative population attributable fraction of carrying one or more high-normal liver enzyme levels (at 80th percentile or over) was 31.4% for GH and 23.2% for PE, respectively. Conclusion: Higher ALT, ALP and GGT levels within the normal range in early pregnancy are associated with increased risk of GH and PE. The documented associations provide new insight to the role of hepatobiliary function in GH and PE pathogenesis.
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