ArticleBMC pregnancy and childbirth2025
Elevated maternal serum aminotransferase in early pregnancy associated with early-onset preeclampsia: A cohort study of 116,967 pregnancies in Shanghai, China.
Article in BMC pregnancy and childbirth, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed.
- Control of HELLP syndrome and pre-eclampsia with microbiota.Molecular biology reports · 2026Review
- Prediction of Pregnancy-Related Complications in Women of Advanced Maternal Age: A Nomogram Based on LASSO and Logistic Regression.International journal of women's health · 2026Article
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9 authors.
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Abstract
inductionPreeclampsia (PE) is a severe pregnancy-specific complications along with multiple organ impairment. However, whether women with elevated serum aminotransferase levels in early pregnancy are susceptible to PE, and even early-onset PE remains unclear. MATERIALS AND
methodsA hospital-based retrospective cohort study involving 116,967 pregnant women delivered between 2014 and 2022 in Shanghai, China was conducted. The study employed restricted cubic splines and logistic regression analysis to investigate the associations between early maternal liver function tests, specifically alanine aminotransferase (ALT), aspartate aminotransferase (AST), and the ALT/AST ratio, and the risk of PE and its subtypes, including early-onset preeclampsia (occurred at < 34 weeks of gestation) and late-onset preeclampsia (occurred at ≥ 34 weeks of gestation).
resultsElevated ALT levels (> 40 IU/L) in early pregnancy were associated with an increased risk of PE (adjusted odds ratio (aOR) = 1.57 [95% confidence interval (CI): 1.38-1.80]), early-onset PE (aOR = 1.78 [95% CI: 1.27-2.48]) and late-onset PE (aOR = 1.53 [95% CI: 1.33-1.76]). Increased risks of PE and early-onset PE were also observed in pregnant women with AST levels > 40 IU/L (aOR = 1.63 [95% CI: 1.33-1.99] for PE; aOR = 1.81 [95% CI: 1.09-3.00] for early-onset PE ) or ALT/AST ratio > 1 (aOR = 1.36 [95% CI: 1.25-1.47] for PE; aOR = 1.66 [95% CI: 1.34-2.06] for early-onset PE). Furthermore, women with abnormal ALT or AST levels in early pregnancy but relieved in later pregnancy periods still had elevated risks of PE and early-onset PE. The stratified analysis demonstrated that women with advanced age complicated with high ALT have increased risk of developing early-onset PE.
conclusionsElevated levels of ALT, AST and their ratios in early pregnancy were associated with an increased risk of PE, especially early-onset PE. Therefore, screening for aminotransferase levels in early pregnancy could be considered for identification of women at high risk of developing liver dysfunction-related PE, or even early-onset PE.
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