Role of Liver Parameters in Preterm Birth: A Prospective Cohort Study.

Authors

Qingxiu Li, Juan Yang, Jiayi Chen, Lili Yang, Qian Zhang, Jinying Chen, Wenjuan Liu, Haiyan Gao, Wei Li, Zhengqin Wu, Bin Sun, Yibing Zhu, Chong Miao, Haibo Li

Published in

Archives of medical research. Volume 58. Issue 1. Pages 103540. Oct 29, 2026. Epub Oct 29, 2026.

Abstract

To investigate the association between liver dysfunction during pregnancy and the risk of preterm birth (PTB).
We conducted a prospective birth cohort study in China that included 23,194 women with singleton pregnancies. Several biomarkers, including total bile acids (TBA), gamma-glutamyl transferase (GGT), aspartate aminotransferase (AST), alanine aminotransferase (ALT), the AST-to-ALT ratio, and total bilirubin (TBiL), were measured in the first and third trimesters. The primary outcome was PTB (delivery before 37 weeks of gestation).
The incidence of PTB among our participants was 5.7%. After multivariable adjustment, increased levels of TBA, GGT, ALT, and AST, as well as abnormal liver function tests (LFTs) in early pregnancy, were associated with a higher risk of PTB. An increased AST-to-ALT ratio was associated with a lower risk of PTB. Furthermore, a nonlinear test revealed a linear association between PTB and TBiL, TBA, GGT, ALT, AST, and the AST-to-ALT ratio in the first trimester. The association between liver enzyme levels and PTB in late pregnancy was similar to that observed in early gestation. In addition, TBiL in late pregnancy was negatively correlated with PTB. Interestingly, a consistent association was observed between GGT and PTB, whether iatrogenic or spontaneous, in both the first and third trimesters (p <0.05).
Associations have been observed between liver enzyme levels in both early and late gestation and the risk of PTB. Consequently, future mechanistic and interventional studies are warranted to further investigate these links.

PMID:
42956423
Bibliographic data and abstract were imported from PubMed on 30 Oct 2026.

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