{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T04:59:01Z","timestamp":1771563541463,"version":"3.50.1"},"reference-count":40,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","license":[{"start":{"date-parts":[[2015,9,1]],"date-time":"2015-09-01T00:00:00Z","timestamp":1441065600000},"content-version":"tdm","delay-in-days":3926,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2004,12]]},"abstract":"<jats:sec>\n            <jats:title\/>\n            <jats:p>\n                                 <jats:bold>Intrahepatic cholestasis of pregnancy (ICP) is a pregnancy\u2013specific liver disease associated with poor maternal and fetal outcome. The diagnosis is based on pruritus with abnormal liver function in the absence of other pathological conditions. However, pruritus in pregnancy is common, and it may be the only presenting feature in ICP. No reliable test currently exists that can discriminate between those women destined to develop ICP and those with the benign condition of pruritus gravidarum (PG). The purpose of this prospective study was to investigate longitudinally the serum concentration of glutathione<\/jats:bold>\n                                 <jats:bold>\n                                    S\n                                 <\/jats:bold>\n                                 <jats:bold>\u2013transferase alpha (GSTA, a specific marker of hepatocellular integrity) and to compare this with the temporal profile of conventional liver function markers in women with ICP (n = 63), PG (n = 43), and normal pregnant controls (n = 26). Blood was sampled on at least 3 separate occasions between 16 weeks of gestation and 4 weeks postpartum. Serum concentrations of GSTA increased with gestation in ICP, being significantly higher from 24 (\u00b12) weeks compared with controls (400% difference; 95% CI, 240%-734%;<\/jats:bold>\n                                 <jats:bold>\n                                    P\n                                 <\/jats:bold>\n                                 <jats:bold>&lt; .001). GSTA was also higher in ICP versus PG (433% difference; 95% CI, 228%\u2013790%;<\/jats:bold>\n                                 <jats:bold>\n                                    P\n                                 <\/jats:bold>\n                                 <jats:bold>&lt; .001) throughout the gestational period studied. Significant differences in the ICP compared with control and PG groups were also found for total bile acids, alanine aminotransferase, aspartate aminotransferase, \u03b3\u2013glutamyl transpeptidase and alkaline phosphatase.<\/jats:bold>\n                                 <jats:bold>\n                                    In conclusion\n                                 <\/jats:bold>\n                                 <jats:bold>, the measurement of GSTA provides a test of liver dysfunction that distinguishes women with ICP from those with PG. Additionally, on the basis of this study, reference ranges for biochemical markers of liver function require reevaluation in pregnancy. (Hepatology 2004;40:1406-1414.)<\/jats:bold>\n                              <\/jats:p>\n          <\/jats:sec>","DOI":"10.1002\/hep.20473","type":"journal-article","created":{"date-parts":[[2004,11,24]],"date-time":"2004-11-24T18:51:53Z","timestamp":1101322313000},"page":"1406-1414","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":37,"title":["Glutathione S \u2013Transferase and Liver Function in Intrahepatic Cholestasis of Pregnancy and Pruritus Gravidarum"],"prefix":"10.1097","volume":"40","author":[{"given":"Anthony T.","family":"Dann","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna P.","family":"Kenyon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul T.","family":"Seed","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucilla","family":"Poston","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew H.","family":"Shennan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachel M.","family":"Tribe","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"R1-24-20241018","doi-asserted-by":"crossref","first-page":"825","DOI":"10.1016\/0016-5085(86)90682-7","article-title":"Serum bile acid concentrations during pregnancy and their relationship to obstetric cholestasis.","volume":"91","author":"Lunzer","year":"1986","journal-title":"Gastroenterology"},{"key":"R2-24-20241018","doi-asserted-by":"crossref","first-page":"1012","DOI":"10.1016\/S0168-8278(00)80139-7","article-title":"Intrahepatic cholestasis of pregnancy: molecular pathogenesis, diagnosis and management.","volume":"33","author":"Lammert","year":"2000","journal-title":"J Hepatol"},{"key":"R3-24-20241018","doi-asserted-by":"crossref","first-page":"580","DOI":"10.1136\/gut.37.4.580","article-title":"Fetal mortality associated with cholestasis of pregnancy and the potential benefit of therapy with ursodeoxycholic acid.","volume":"37","author":"Davies","year":"1995","journal-title":"Gut"},{"key":"R4-24-20241018","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1016\/0002-9378(79)90683-5","article-title":"Obstetric cholestasis: a 14 year review.","volume":"133","author":"Johnston","year":"1979","journal-title":"Am J Obstet Gynecol"},{"key":"R5-24-20241018","doi-asserted-by":"crossref","first-page":"1137","DOI":"10.1111\/j.1471-0528.1988.tb06791.x","article-title":"Fetal outcome in obstetric cholestasis.","volume":"95","author":"Fisk","year":"1988","journal-title":"Br J Obstet Gynaecol"},{"key":"R6-24-20241018","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1111\/j.1440-1746.1997.tb00410.x","article-title":"Review: intrahepatic cholestasis: a puzzling disorder of pregnancy.","volume":"12","author":"Reyes","year":"1997","journal-title":"J Gastroenterol Hepatol"},{"key":"R8-24-20241018","first-page":"1190","article-title":"Pruritus may precede abnormal liver function tests in pregnant women with obstetric cholestasis: a longitudinal analysis.","volume":"108","author":"Kenyon","year":"2001","journal-title":"Br J Obstet Gynaecol"},{"key":"R9-24-20241018","first-page":"671A","article-title":"Pruritus in pregnancy and the identification of those at risk of obstetric cholestasis: a prospective prevalence study of 6531 women. Abstract.","volume":"9","author":"Kenyon","year":"2002","journal-title":"J Soc Gynecol Invest"},{"key":"R10-24-20241018","doi-asserted-by":"crossref","first-page":"734","DOI":"10.1001\/archderm.1994.01690060064006","article-title":"Specific pruritic diseases of pregnancy: a prospective study of 3192 pregnant women.","volume":"130","author":"Roger","year":"1994","journal-title":"Arch Dermatol"},{"key":"R11-24-20241018","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1016\/0009-8981(88)90325-7","article-title":"Glutathione S-transferase levels in autoimmune chronic active hepatitis: a more sensitive index of hepatocellular damage than aspartate transaminase.","volume":"172","author":"Hayes","year":"1988","journal-title":"Clin Chim Acta"},{"key":"R12-24-20241018","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1016\/S0065-2423(08)60198-5","article-title":"Glutathione S-transferases: biomedical applications.","volume":"30","author":"Beckett","year":"1993","journal-title":"Adv Clin Chem"},{"issue":"9213","key":"R13-24-20241018","doi-asserted-by":"crossref","first-page":"1463","DOI":"10.1016\/S0140-6736(05)74662-6","article-title":"A marker for hepatocellular damage.","volume":"355","author":"Knapen","year":"2000","journal-title":"Lancet"},{"key":"R14-24-20241018","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1111\/j.1471-0528.1997.tb11054.x","article-title":"Liver function tests in pre-eclampsia: importance of comparison with a reference range derived for normal pregnancy.","volume":"104","author":"Girling","year":"1997","journal-title":"Br J Obstet Gynaecol"},{"key":"R15-24-20241018","first-page":"247","article-title":"Tobit models: a survey.","volume":"11","author":"Amemiya","year":"1984","journal-title":"J Econ"},{"key":"R17-24-20241018","first-page":"443","article-title":"Glutathione S-transferase distribution and concentration in human organs.","volume":"16","author":"Corrigall","year":"1988","journal-title":"Biochem Int"},{"key":"R18-24-20241018","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1016\/S0002-9378(98)70645-3","article-title":"Plasma glutathione S-transferase alpha 1-1: a more sensitive marker for hepatocellular damage than serum alanine aminotransferase in hypertensive disorders of pregnancy.","volume":"178","author":"Knapen","year":"1998","journal-title":"Am J Obstet Gynecol"},{"key":"R19-24-20241018","doi-asserted-by":"crossref","first-page":"416","DOI":"10.1093\/clinchem\/42.3.416","article-title":"Sandwich ELISA for glutathione S-transferase alpha 1-1: plasma concentrations in controls and in patients with gastrointestinal disorders.","volume":"42","author":"Mulder","year":"1996","journal-title":"Clin Chem"},{"key":"R20-24-20241018","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1111\/j.1471-0528.1981.tb00975.x","article-title":"Changes in serum bile acid concentrations during normal pregnancy, in patients with intrahepatic cholestasis of pregnancy and in pregnant women with itching.","volume":"88","author":"Heikkinen","year":"1981","journal-title":"Br J Obstet Gynaecol"},{"key":"R21-24-20241018","first-page":"313","article-title":"Serum bile acids in cholestasis of pregnancy.","volume":"50","author":"Laatikainen","year":"1977","journal-title":"Obstet Gynecol"},{"key":"R22-24-20241018","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1111\/j.1479-828X.1988.tb01657.x","article-title":"Maternal features of obstetric cholestasis: 20 years experience at King George V Hospital.","volume":"28","author":"Fisk","year":"1988","journal-title":"Aust N Z J Obstet Gynaecol"},{"key":"R23-24-20241018","first-page":"490","article-title":"Umbilical cord plasma glutathione S-transferase alpha 1-1 levels as a marker of neonatal hepatocellular integrity.","volume":"91","author":"Knapen","year":"1998","journal-title":"Obstet Gynecol"},{"key":"R24-24-20241018","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1097\/00005237-200006000-00004","article-title":"Intrahepatic cholestasis of pregnancy: a critical review.","volume":"14","author":"Palmer","year":"2000","journal-title":"J Perinat Neonatal Nurs"},{"key":"R25-24-20241018","first-page":"581","article-title":"Serum bile acids in the early diagnosis of intrahepatic cholestasis of pregnancy.","volume":"61","author":"Heikkinen","year":"1983","journal-title":"Obstet Gynecol"},{"key":"R26-24-20241018","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1002\/hep.510260216","article-title":"Intrahepatic cholestasis of pregnancy: a French prospective study.","volume":"26","author":"Bacq","year":"1997","journal-title":"HEPATOLOGY"},{"key":"R27-24-20241018","doi-asserted-by":"crossref","first-page":"890","DOI":"10.1016\/S0002-9378(94)70304-3","article-title":"Intrahepatic cholestasis of pregnancy: a retrospective case-control study of perinatal outcome.","volume":"170","author":"Rioseco","year":"1994","journal-title":"Am J Obstet Gynecol"},{"key":"R28-24-20241018","first-page":"215","article-title":"Clinical and laboratory characterization in 100 cases of pregnancy cholestasis. .","volume":"47","author":"Lopez","year":"1982","journal-title":"Rev Chil Obstet Ginecol"},{"key":"R29-24-20241018","first-page":"123","article-title":"Itching during pregnancy.","volume":"64","author":"Ylostalo","year":"1975","journal-title":"Ann Chir Gynaecol Fenn"},{"key":"R30-24-20241018","doi-asserted-by":"crossref","first-page":"417","DOI":"10.3109\/00016348009155420","article-title":"Radioimmunoassay of serum bile acids in normal pregnancy and in recurrent cholestasis of pregnancy.","volume":"59","author":"Samuelson","year":"1980","journal-title":"Acta Obstet Gynecol Scand"},{"key":"R31-24-20241018","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1016\/0009-8981(93)90117-M","article-title":"Biological variability of twenty-five serum analytes during normal pregnancy.","volume":"214","author":"Alberty","year":"1993","journal-title":"Clin Chim Acta"},{"key":"R32-24-20241018","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1016\/S0146-0005(98)80042-6","article-title":"Intrahepatic cholestasis of pregnancy.","volume":"22","author":"Davidson","year":"1998","journal-title":"Semin Perinatol"},{"key":"R33-24-20241018","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1007\/s11938-003-0013-x","article-title":"Intrahepatic cholestasis of pregnancy.","volume":"6","author":"Lammert","year":"2003","journal-title":"Curr Treat Options Gastroenterol"},{"key":"R34-24-20241018","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1016\/0020-7292(84)90019-5","article-title":"Maternal serum bile acid levels and fetal distress in cholestasis of pregnancy.","volume":"22","author":"Laatikainen","year":"1984","journal-title":"Int J Gynaecol Obstet"},{"key":"R35-24-20241018","doi-asserted-by":"crossref","first-page":"17","DOI":"10.3109\/01443618309071218","article-title":"Bile acids in maternal serum, umbilical cord serum and amniotic fluid of healthy women, women with pruritis and patients with intrahepatic cholestasis of pregnancy.","volume":"4","author":"Heikkinen","year":"1983","journal-title":"J Obstet Gynaecol"},{"key":"R36-24-20241018","doi-asserted-by":"crossref","first-page":"1283","DOI":"10.1046\/j.1440-1746.2003.03171.x","article-title":"Obstetric cholestasis with elevated gamma glutamyl transpeptidase: incidence, presentation and treatment.","volume":"18","author":"Milkiewicz","year":"2003","journal-title":"J Gastroenterol Hepatol"},{"key":"R37-24-20241018","doi-asserted-by":"crossref","first-page":"1209","DOI":"10.1093\/hmg\/9.8.1209","article-title":"Heterozygous MDR3 missense mutation associated with intrahepatic cholestasis of pregnancy: evidence for a defect in protein trafficking.","volume":"9","author":"Dixon","year":"2000","journal-title":"Hum Mol Genet"},{"key":"R38-24-20241018","doi-asserted-by":"crossref","first-page":"876","DOI":"10.1136\/gut.51.6.876","article-title":"Prospective study of liver dysfunction in pregnancy in Southwest Wales.","volume":"51","author":"Chng","year":"2002","journal-title":"Gut"},{"key":"R39-24-20241018","first-page":"768","article-title":"Cholestasis in pregnancy and normal serum gammaglutamyl transpeptidase activity. .","volume":"12","author":"Jacquemin","year":"1988","journal-title":"Gastroenterol Clin Biol"},{"key":"R40-24-20241018","doi-asserted-by":"crossref","first-page":"1025","DOI":"10.1136\/gut.52.7.1025","article-title":"Genetic evidence of heterogeneity in intrahepatic cholestasis of pregnancy.","volume":"52","author":"Savander","year":"2003","journal-title":"Gut"},{"key":"R41-24-20241018","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/S0301-2115(98)00086-4","article-title":"Relevance of serum bile acid profile in the diagnosis of intrahepatic cholestasis of pregnancy in an high incidence area: Portugal.","volume":"80","author":"Brites","year":"1998","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"R42-24-20241018","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1002\/hep.1840020114","article-title":"The enigma of intrahepatic cholestasis of pregnancy: lessons from Chile.","volume":"2","author":"Reyes","year":"1982","journal-title":"HEPATOLOGY"}],"container-title":["Hepatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fhep.20473","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/01515467-200412000-00024","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,18]],"date-time":"2024-10-18T21:11:56Z","timestamp":1729285916000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/01515467-200412000-00024"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2004,12]]},"references-count":40,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2004]]}},"URL":"https:\/\/doi.org\/10.1002\/hep.20473","relation":{},"ISSN":["0270-9139"],"issn-type":[{"value":"0270-9139","type":"print"}],"subject":[],"published":{"date-parts":[[2004,12]]}}}