The associations of maternal liver biomarkers in different trimesters with birth weight outcomes.

We aimed to examine the association of maternal liver biomarkers in different trimesters and their changes with outcomes of neonatal birth weight. This prospective pregnant cohort study included pregnant women with the first prenatal follow-up record, the birth registration record and at least one record of liver function tests during pregnancy at Zhoushan Maternal and Child Care Hospital. Liver enzymes were routinely measured at the first (T1), second (T2) and third trimester (T3). Our study included 12,728 mother-infant pairs, of which 1,003 (7.89%) developed low birth weight (LBW)/small for gestational age (SGA) and 1,047 (8.23%) developed macrosomia/large for gestational age (LGA), respectively. The highest quartile of maternal ALT, AST, and GGT at T2, as well as the change of GGT during pregnancy were significantly associated with a higher risk of LBW/SGA. In addition, pregnant women with higher levels of ALP and AST/ALT at T3 had an increased risk of delivering infants with macrosomia/LGA, and higher early pregnancy levels and greater increases in AST/ALT were also related to an increased risk of macrosomia/LGA. Elevated levels of liver biomarkers are associated with adverse birth weight outcomes.