Fetomaternal outcome in cases of pregnancy with deranged transaminases

Objective: To evaluate the fetomaternal outcomes associated with abnormal transaminases in late pregnancy and to identify maternal factors predictive of adverse neonatal outcomes. Material and Methods: This cross-sectional analytical study was conducted at the Department of Obstetrics & Gynecology, CMH Gujranwala, from 15-10-2025 to 14-01-2026. A total of 110 pregnant women with gestational age ≥32 weeks and elevated transaminases were included. SPSS 27 was used for data analysis. Quantitative data were expressed as mean (SD) or median (IQR), and qualitative data as frequencies and percentages. Mann-Whitney U test, independent-samples t-test, and chi-square test were used, with a p-value ≤0.05 considered significant. Results: All participants had elevated transaminases. The median age was 28.0 years and median gestational age was 35.0 weeks. AST levels were significantly higher in women with NICU admission compared to those without (p=0.005). ALT levels were also significantly higher in women with NICU admission (p=0.003). BMI was significantly higher in women with NICU admission (p=0.006). AST was significantly associated with IUGR (p=0.014), while ALT showed no significant association (p=0.086). Preeclampsia was not significantly associated with IUGR (p=0.131) or NICU admission (p=0.110). Deranged transaminases, fatty liver disease, cesarean section, and preterm delivery were significantly associated with adverse neonatal outcomes (p<0.05). Conclusion: Elevated maternal AST in late pregnancy is significantly associated with adverse neonatal outcomes, including IUGR and NICU admission. ALT elevation is significantly associated with NICU admission but not with IUGR. Maternal obesity, fatty liver disease, cesarean section, and preterm delivery are significant contributors to adverse outcomes. Keywords:HELLP syndrome, Intrauterine Growth Restriction, Transaminases.