Markedly elevated liver enzymes in pregnancy: A 10-year review of cases in a tertiary maternal hospital in Brisbane, Australia

Abnormalities of liver function are common during pregnancy. This retrospective study examined the incidence, aetiology and adequacy of investigation of pregnant women with markedly elevated aspartate aminotransferase and/or alanine transaminase levels (more than 10-fold of the upper limit of normal) over a ten-year period at a tertiary referral maternity hospital in Brisbane, Australia. Three hundred and twenty-three women were found to have markedly elevated liver enzymes, representing 0.56% of pregnancies with known delivery outcomes. Two hundred and sixty-four cases (82%) were due to pregnancy-specific causes. No cause was identified in 12 women (3.8%) despite investigation. No adverse maternal, fetal or neonatal outcome occurred in these pregnancies where no cause was identified for markedly elevated liver enzymes. A further six women (1.9%) did not have comprehensive investigation into underlying aetiologies of elevated liver enzymes.