Liver function tests in Nigerian women with severe preeclampsia

Background: Preeclampsia is a common complication of pregnancy with high maternal and perinatal morbidity and mortality. The new American College of Obstetricians and Gynecologists (ACOG) guideline now includes elevation of liver enzymes as a criterion for the diagnosis of preeclampsia. Objectives: The objectives of this study is to compare liver function tests in preeclampsia and normotensive pregnancy and determine their relationship with systolic and diastolic blood pressure, plasma creatinine, and uric acid levels in Nigerian women with severe preeclampsia. Materials and Methods: This was a case-control study of 46 women with severe preeclampsia and 21 pregnant women as controls. These women attended the Antenatal Clinic at the Lagos University Teaching Hospital, Lagos where women were consecutively recruited. Results: There was a statistically significant difference in the systolic blood pressure (P = 0.002), diastolic blood pressure (P = 0.004), plasma creatinine (P = 0.007), uric acid (P = 0.0001), plasma albumin (P = 0.029), alkaline phosphatase (ALP) (P = 0.0001), aspartate aminotransferase (AST) (P = 0.0001), γ-glutamyl transferase (GGT) (P = 0.035), and unconjugated bilirubin (P = 0.023) between the group with severe preeclampsia and the normotensive pregnancy control group. Alanine aminotransferase (ALT) was however not significantly elevated. AST elevation was the most common anomaly in severe preeclampsia occurring in 54.3% of cases. There was no association between systolic and diastolic blood pressure, plasma creatinine, and uric acid in severe preeclampsia with and without abnormal liver function tests. Conclusion: Elevation of AST, ALP, GGT, and unconjugated bilirubin are common in Nigerian women with severe preeclampsia but may not all be of liver origin. These parameters were also not associated with indices of disease severity. The use of liver enzyme concentrations as adjuncts in preeclampsia diagnosis should be applied with caution in Nigerian women with preeclampsia.