Original Articles

Evaluation of Liver Enzymes in Normal Pregnancies in a University Hospital of Zabol Iran: A Cross-Sectional Study


Objective: Changes in endocrine, nervous, renal, cardiovascular, and respiratory systems during pregnancy have been studied, but changes in liver function have been poorly studied. Therefore, the purpose of this study was to investigate the trend of changes in liver enzymes in normal pregnancy.
Materials and methods: This prospective longitudinal study included 68 pregnant women who were referred to the Obstetrics and Gynecology Clinic of Amiral Momenin Hospital in Zabol in 2021. In terms of the trimester of pregnancy, the presence of underlying diseases, history of previous pregnancies, disorders of the enzymes of recent patients, the patients were evaluated, and the information from the patients' files was analyzed.
Results: The average AST levels in pregnant women in the first, second, and third trimesters were 16.82, 17.47, and 18.00, respectively, which show that garlic consumption is increasing. The average PT in pregnant women decreased in the first, second, and third trimesters. The average direct and total bilirubin levels in pregnant women in the first and second trimesters showed a constant trend. The amount of total protein increased in pregnant women during the first, second, and third trimesters. In the second and third trimesters, the enzyme level was significantly higher in pregnant women than in nonpregnant women. The level of GGT in pregnant women in the first, second, and third trimesters showed a different trend.
Conclusion: Accurate evaluation of patients, especially in the third trimester, is necessary from the point of view of increasing enzyme levels in other countries.


1. Angel García AL. Effect of pregnancy on pre-existing liver disease physiological changes during pregnancy. Ann Hepatol. 2006 ;5(3):184-6.
2. Kondrackiene J, Kupcinskas L. Liver diseases unique to pregnancy. Medicina (Kaunas). 2008;44(5):337-45.
3. Hepburn IS, Schade RR. Pregnancy-associated liver disorders. Dig Dis Sci. 2008;53(9): 2334-58.
4. Chopra S, Griffin PH. Laboratory tests and diagnostic procedures in evaluation of liver disease. Am J Med. 1985;79(2):221-30.
5. Bacq Y. The Liver in Normal Pregnancy. In: Madame Curie Bioscience Database [Internet]. Austin (TX): Landes Bioscience; 2000-2013. Available from: https://www.ncbi.nlm.nih.gov/books/NBK6005/
6. Shekhar S, Diddi G. Liver disease in pregnancy. Taiwan J Obstet Gynecol. 2015;54(5):475-82.
7. Liu M, Cai H, Yi W. Safety of telbivudine treatment for chronic hepatitis B for the entire pregnancy. J Viral Hepat. 2013;20 Suppl 1:65-70
8. Joshi D, James A, Quaglia A, Westbrook RH, Heneghan MA. Liver disease in pregnancy. Lancet. 2010;375(9714):594-605.
9. Mikolasevic I, Filipec-Kanizaj T, Jakopcic I, Majurec I,
Brncic-Fischer A, Sobocan N, et al. Liver Disease During Pregnancy: A Challenging Clinical Issue. Med Sci Monit. 2018 Jun 15;24:4080-4090.
10. Kelly C, Pericleous M. Pregnancy-associated liver disease: a curriculum-based review. Frontline Gastroenterol. 2018;9(3):170-174.
11. Kamimura K, Abe H, Kawai H, Kamimura H, Kobayashi Y, Nomoto M, et al. Advances in understanding and treating liver diseases during pregnancy: A review. World J Gastroenterol. 2015;21(17):5183-90.
12. Bacq Y, Zarka O, Bréchot JF, Mariotte N, Vol S, Tichet J, Weill J. Liver function tests in normal pregnancy: a prospective study of 103 pregnant women and 103 matched controls. Hepatology. 1996;23(5):1030-4.
13. Ghulmiyyah L, Sibai B. Maternal mortality from preeclampsia/eclampsia. Semin Perinatol. 2012;36(1):56-9.
14. Tessema G, Tekeste A, Ayele T. Preeclampsia and associated factors among pregnant women attending antenatal care in Dessie referral hospital, Northeast Ethiopia: A hospital-based study. BMC Pregnancy and Childbirth. 2015; 15. 10.1186/s12884-015-0502-7. https://doi.org/10.1186/s12884-015-0502-7 PMID:25880924
15. Jasovic-Siveska E, Jasovic V. Demographic characteristics in preeclamptic women in Macedonia. Rev Med Chil. 2011;139(6):748-54.
16. Ushida T, Kotani T, Kinoshita F, Imai K, Nakano-Kobayashi T, Nakamura N, Moriyama Y, Yoshida S, Yamashita M, Kajiyama H. Liver transaminase levels during pregnancy: a Japanese multicenter study.
J Matern Fetal Neonatal Med. 2022;35(25):5761-5767.
17. Hassen FS, Malik T, Dejenie TA. Evaluation of serum uric acid and liver function tests among pregnant women with and without preeclampsia at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia. PLoS One.
18. Salman MI. Changes in liver functions tests during pregnancy. J. of al-anbar Univer. Pure Sci. 2009;3(1).
19. Younas A, Gilani M, Asif N, Aamir M, Ali A. Determination of Reference interval of liver function tests during Pregnancy in urban area of district Rawalpindi Pakistan. Pakistan Armed Forces Medical Journal. 2021;71(Suppl-1): S250-54.
20. Girling JC, Dow E, Smith JH. Liver function tests in pre-eclampsia: importance of comparison with a reference range derived for normal pregnancy. Br J Obstet Gynaecol. 1997;104(2):246-50.
21. Naz R, Habib B, Bashir F, Ahmed S, Kazi A, Nisar S. Assessment of Pregnant Women for Information About Hypertension in Pregnancy: A Cross Sectional Study from a Teaching Hospital Outdoor. Pakistan Journal of Medical & Health Sciences. 2022;16(12):600-.
22. García-Romero CS, Guzman C, Cervantes A, Cerbón M. Liver disease in pregnancy: Medical aspects and their implications for mother and child. Annals of hepatology. 2019 Jul 1;18(4):553-62.
23. Al-Hamdani A H, Al-Doski F S. Evaluation of some liver function tests during different gestational period. Rafidain Journal of Science. 2012;23(1):44-51.
24. Prakash S, Pandeya RD. Biochemical analysis of Liver Function Test in different trimesters of Pregnancy. International Journal of Biomedical Research. 2019;10(11):e5316.
IssueVol 17, No 3 (September 2023) QRcode
SectionOriginal Articles
DOI https://doi.org/10.18502/jfrh.v17i3.13542
Liver Function Tests Pregnancy Alanine Aminotransferase (ALT) Aspartate Aminotransferase (AST) Bilirubin

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How to Cite
Shahramian I, Rezaie Kahkhaie L, Rezaie Keikhaie K, Shirdel Kahkha Zhaleh M, Afshari M. Evaluation of Liver Enzymes in Normal Pregnancies in a University Hospital of Zabol Iran: A Cross-Sectional Study. J Family Reprod Health. 2023;17(3):185-190.