{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T14:19:05Z","timestamp":1793369945177,"version":"4.5.0"},"reference-count":50,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2020,10,1]],"date-time":"2020-10-01T00:00:00Z","timestamp":1601510400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2020,10,1]],"date-time":"2020-10-01T00:00:00Z","timestamp":1601510400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Best Practice &amp; Research Clinical Obstetrics &amp; Gynaecology"],"published-print":{"date-parts":[[2020,10]]},"DOI":"10.1016\/j.bpobgyn.2020.02.011","type":"journal-article","created":{"date-parts":[[2020,3,7]],"date-time":"2020-03-07T02:02:26Z","timestamp":1583546546000},"page":"2-11","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":23,"special_numbering":"C","title":["Implications of abnormal liver function in pregnancy and non-alcoholic fatty liver disease"],"prefix":"10.1016","volume":"68","author":[{"given":"Terence T.","family":"Lao","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.bpobgyn.2020.02.011_bib1","doi-asserted-by":"crossref","first-page":"933","DOI":"10.1016\/j.jhep.2015.11.030","article-title":"Pregnancy and liver disease","volume":"64","author":"Westbrook","year":"2016","journal-title":"J\u00a0Hepatol"},{"key":"10.1016\/j.bpobgyn.2020.02.011_bib2","doi-asserted-by":"crossref","first-page":"1030","DOI":"10.1002\/hep.510230514","article-title":"Liver function tests in normal pregnancy: a prospective study of 103 pregnant women and 103 matched controls","volume":"23","author":"Bacq","year":"1996","journal-title":"Hepatology"},{"key":"10.1016\/j.bpobgyn.2020.02.011_bib3","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":"10.1016\/j.bpobgyn.2020.02.011_bib4","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1016\/S1665-2681(19)32009-5","article-title":"Effect of pregnancy on pre-existing liver disease: chronic viral hepatitis","volume":"5","author":"Sookoian","year":"2006","journal-title":"Ann Hepatol"},{"key":"10.1016\/j.bpobgyn.2020.02.011_bib5","doi-asserted-by":"crossref","first-page":"4677","DOI":"10.3748\/wjg.v18.i34.4677","article-title":"Hepatitis B in pregnancy","volume":"18","author":"Borgia","year":"2012","journal-title":"World J Gastroenterol"},{"key":"10.1016\/j.bpobgyn.2020.02.011_bib6","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":"Ch\u2019ng","year":"2002","journal-title":"Gut"},{"key":"10.1016\/j.bpobgyn.2020.02.011_bib7","doi-asserted-by":"crossref","first-page":"204","DOI":"10.47102\/annals-acadmedsg.V33N2p204","article-title":"Abnormal liver function tests in the symptomatic pregnant patient: the local experience in Singapore","volume":"33","author":"Wong","year":"2004","journal-title":"Ann Acad Med Singapore"},{"key":"10.1016\/j.bpobgyn.2020.02.011_bib8","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1097\/SGA.0000000000000004","article-title":"Liver function tests in viremic and nonviremic chronic hepatitis B virus-infected pregnant women","volume":"36","author":"Elefsiniotis","year":"2013","journal-title":"Gastroenterol Nurs"},{"key":"10.1016\/j.bpobgyn.2020.02.011_bib9","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1080\/00365540410027111","article-title":"Serum ALT levels as a surrogate marker for serum HBV DNA levels in HBeAg-negative pregnant women","volume":"36","author":"Sangfelt","year":"2004","journal-title":"Scand J Infect Dis"},{"key":"10.1016\/j.bpobgyn.2020.02.011_bib10","doi-asserted-by":"crossref","first-page":"f6055","DOI":"10.1136\/bmj.f6055","article-title":"Abnormal liver function tests in pregnancy","volume":"347","author":"Walker","year":"2013","journal-title":"Br Med J"},{"issue":"12","key":"10.1016\/j.bpobgyn.2020.02.011_bib11","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0051165","article-title":"Serum \u03b3-glutamyl transferase levels, insulin resistance and liver fibrosis in patients with chronic liver disease","volume":"7","author":"Petta","year":"2012","journal-title":"PloS One"},{"key":"10.1016\/j.bpobgyn.2020.02.011_bib12","doi-asserted-by":"crossref","first-page":"1369","DOI":"10.1136\/gutjnl-2015-309260","article-title":"The gamma-glutamyl transpeptidase to platelet ratio (GPR) predicts significant liver fibrosis and cirrhosis in patients with chronic HBV infection in West Africa","volume":"65","author":"Lemoine","year":"2016","journal-title":"Gut"},{"issue":"10","key":"10.1016\/j.bpobgyn.2020.02.011_bib13","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0047687","article-title":"Comprehensive analysis of common serum liver enzymes as prospective predictors of hepatocellular carcinoma in HBV patients","volume":"7","author":"Hann","year":"2012","journal-title":"PloS One"},{"key":"10.1016\/j.bpobgyn.2020.02.011_bib14","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1111\/j.1447-0756.2008.00815.x","article-title":"Gamma-glutamyltransferase level in pregnancy is an independent risk factor for gestational diabetes mellitus","volume":"34","author":"Tan","year":"2008","journal-title":"J\u00a0Obstet Gynaecol Res"},{"key":"10.1016\/j.bpobgyn.2020.02.011_bib15","doi-asserted-by":"crossref","first-page":"208","DOI":"10.3109\/09513590.2011.588756","article-title":"Can serum gamma-glutamyltrasnferase levels be useful at diagnosing gestational diabetes mellitus?","volume":"28","author":"Alanbay","year":"2012","journal-title":"Gynecol Endocrinol"},{"key":"10.1016\/j.bpobgyn.2020.02.011_bib16","doi-asserted-by":"crossref","first-page":"1878","DOI":"10.2337\/dc13-2229","article-title":"Pregravid liver enzyme levels and risk of gestational diabetes mellitus during a subsequent pregnancy","volume":"37","author":"Sridhar","year":"2014","journal-title":"Diabetes Care"},{"key":"10.1016\/j.bpobgyn.2020.02.011_bib17","doi-asserted-by":"crossref","first-page":"581","DOI":"10.3389\/fendo.2018.00581","article-title":"Liver enzymes in early to mid-pregnancy, insulin resistance, and gestational diabetes risk: a longitudinal analysis","volume":"9","author":"Zhu","year":"2018","journal-title":"Front Endocrinol"},{"key":"10.1016\/j.bpobgyn.2020.02.011_bib18","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1089\/met.2015.0106","article-title":"The association of alanine aminotransferase in early pregnancy with gestational diabetes","volume":"14","author":"Yarrington","year":"2018","journal-title":"Metab Syndr Relat Disord"},{"key":"10.1016\/j.bpobgyn.2020.02.011_bib19","doi-asserted-by":"crossref","first-page":"474","DOI":"10.1016\/j.ajog.2016.04.051","article-title":"The association of early unexplained elevated alanine aminotransferase with large-for-gestational-age birthweight","volume":"215","author":"Yarrington","year":"2016","journal-title":"Am J Obstet Gynecol"},{"key":"10.1016\/j.bpobgyn.2020.02.011_bib20","doi-asserted-by":"crossref","first-page":"27291","DOI":"10.1038\/srep27291","article-title":"Plasma levels of alanine aminotransferase in the first trimester identify high risk Chinese women for gestational diabetes","volume":"6","author":"Leng","year":"2016","journal-title":"Sci Rep"},{"key":"10.1016\/j.bpobgyn.2020.02.011_bib21","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1186\/1472-6823-12-16","article-title":"Association of alanine aminotransferase levels (ALT) with the hepatic insulin resistance index (HIRI): a cross-sectional study","volume":"12","author":"G\u00f3mez-S\u00e1mano","year":"2012","journal-title":"BMC Endocr Disord"},{"key":"10.1016\/j.bpobgyn.2020.02.011_bib22","doi-asserted-by":"crossref","first-page":"250","DOI":"10.3109\/14767058.2012.733771","article-title":"Prediction of preeclampsia: liver function tests during the first 20 gestational weeks","volume":"26","author":"Mei-Dan","year":"2013","journal-title":"J\u00a0Matern Fetal Neonatal Med"},{"key":"10.1016\/j.bpobgyn.2020.02.011_bib23","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1111\/j.1365-2036.2011.04724.x","article-title":"Systematic review: the epidemiology and natural history of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis in adults","volume":"34","author":"Vernon","year":"2011","journal-title":"Aliment Pharmacol Ther"},{"key":"10.1016\/j.bpobgyn.2020.02.011_bib24","doi-asserted-by":"crossref","first-page":"g4596","DOI":"10.1136\/bmj.g4596","article-title":"Non-alcoholic fatty liver disease","volume":"349","author":"Sattar","year":"2014","journal-title":"Br Med J"},{"key":"10.1016\/j.bpobgyn.2020.02.011_bib25","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1002\/hep.28524","article-title":"The globalization of nonalcoholic fatty liver disease: prevalence and impact on world health","volume":"64","author":"Rinella","year":"2016","journal-title":"Hepatology"},{"key":"10.1016\/j.bpobgyn.2020.02.011_bib26","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/j.metabol.2017.09.016","article-title":"Polycystic ovarian syndrome (PCOS): long term metabolic consequences","volume":"86","author":"Anagnostis","year":"2018","journal-title":"Metabolism"},{"key":"10.1016\/j.bpobgyn.2020.02.011_bib27","doi-asserted-by":"crossref","first-page":"1649","DOI":"10.1038\/s41395-018-0088-6","article-title":"NASH leading cause of liver transplant in women: updated analysis of indications for liver transplant and ethnic and gender variances","volume":"113","author":"Nouredin","year":"2018","journal-title":"Am J Gastroenterol"},{"key":"10.1016\/j.bpobgyn.2020.02.011_bib28","first-page":"725","article-title":"The clinical characteristics and etiological study of nonalcoholic fatty liver disease in Chinese women with PCOS","volume":"11","author":"Qu","year":"2013","journal-title":"Iran J Reproductive Med"},{"key":"10.1016\/j.bpobgyn.2020.02.011_bib29","doi-asserted-by":"crossref","first-page":"17932","DOI":"10.3748\/wjg.v20.i47.17932","article-title":"Lean-non-alcoholic fatty liver disease increases risk for metabolic disorders in a normal weight Chinese population","volume":"20","author":"Feng","year":"2014","journal-title":"World J Gastroenterol"},{"issue":"6","key":"10.1016\/j.bpobgyn.2020.02.011_bib30","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0178473","article-title":"Liver biopsy in type 2 diabetes mellitus: steatohepatitis represents the sole feature of liver damage","volume":"12","author":"Masarone","year":"2017","journal-title":"PloS One"},{"key":"10.1016\/j.bpobgyn.2020.02.011_bib31","doi-asserted-by":"crossref","first-page":"646","DOI":"10.1016\/j.numecd.2008.12.007","article-title":"Non-alcoholic fatty liver disease is associated with left ventricular diastolic dysfunction in essential hypertension","volume":"19","author":"Fallo","year":"2009","journal-title":"Nutr Metabol Cardiovasc Dis"},{"key":"10.1016\/j.bpobgyn.2020.02.011_bib32","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1007\/s12072-018-9916-4","article-title":"Lean non-alcoholic fatty liver disease (lean NAFLD): characteristics, metabolic outcomes and risk factors from a 7-year prospective, community cohort study from Sri Lanka","volume":"13","author":"Niriella","year":"2019","journal-title":"Hepatol Int"},{"key":"10.1016\/j.bpobgyn.2020.02.011_bib33","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1097\/TP.0000000000002484","article-title":"Epidemiology of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis: implications for liver transplantation","volume":"103","author":"Younossi","year":"2019","journal-title":"Transplantation"},{"key":"10.1016\/j.bpobgyn.2020.02.011_bib34","doi-asserted-by":"crossref","first-page":"402","DOI":"10.1016\/S1665-2681(19)31616-3","article-title":"Prevalence of non-alcoholic fatty liver disease in premenopausal, postmenopausal and polycystic ovary syndrome women. The role of estrogens","volume":"9","author":"Gutierrez-Grobe","year":"2010","journal-title":"Ann Hepatol"},{"key":"10.1016\/j.bpobgyn.2020.02.011_bib35","doi-asserted-by":"crossref","first-page":"3709","DOI":"10.1210\/jc.2012-1382","article-title":"Polycystic ovary syndrome with hyperandrogenism is characterized by an increased risk of hepatic steatosis compared to nonhyperandrogenic PCOS phenotypes and healthy controls, independent of obesity and insulin resistance","volume":"97","author":"Jones","year":"2012","journal-title":"J\u00a0Clin Endocrinol Metab"},{"key":"10.1016\/j.bpobgyn.2020.02.011_bib36","doi-asserted-by":"crossref","first-page":"479","DOI":"10.3109\/00365521.2010.539251","article-title":"Non-alcoholic steatohepatitis (NASH) in patients with polycystic ovarian syndrome (PCOS)","volume":"46","author":"Hossain","year":"2011","journal-title":"Scand J Gastroenterol"},{"key":"10.1016\/j.bpobgyn.2020.02.011_bib37","first-page":"221","article-title":"Implications of nonalcoholic fatty liver disease on pregnancy and maternal and child outcomes","volume":"15","author":"Hershman","year":"2019","journal-title":"Gastroenterol Hepatol"},{"key":"10.1016\/j.bpobgyn.2020.02.011_bib38","doi-asserted-by":"crossref","first-page":"1532","DOI":"10.1111\/j.1471-0528.2011.03070.x","article-title":"A\u00a0novel cause for abnormal liver function tests in pregnancy and the puerperium: non-alcoholic fatty liver disease","volume":"118","author":"Page","year":"2011","journal-title":"Br J Obstet Gynaecol"},{"key":"10.1016\/j.bpobgyn.2020.02.011_bib39","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1111\/liv.12902","article-title":"Adverse outcomes of pregnancy in women with non-alcoholic fatty liver disease","volume":"36","author":"Hagstr\u00f6m","year":"2016","journal-title":"Liver Int"},{"key":"10.1016\/j.bpobgyn.2020.02.011_bib40","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1038\/ajg.2016.43","article-title":"Non-alcoholic fatty liver disease in early pregnancy predicts dysglycemia in mid-pregnancy: prospective study","volume":"111","author":"De Souza","year":"2016","journal-title":"Am J Gastroenterol"},{"key":"10.1016\/j.bpobgyn.2020.02.011_bib41","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1007\/s00125-018-4779-8","article-title":"Non-alcoholic fatty liver disease in the first trimester and subsequent development of gestational diabetes mellitus","volume":"62","author":"Lee","year":"2019","journal-title":"Diabetologia"},{"issue":"4","key":"10.1016\/j.bpobgyn.2020.02.011_bib42","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0215326","article-title":"Non-alcoholic fatty liver disease and pregnancy complications among Sri Lankan women: a cross sectional analytic study","volume":"14","author":"Herath","year":"2019","journal-title":"PloS One"},{"key":"10.1016\/j.bpobgyn.2020.02.011_bib43","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1080\/09674845.2018.1492205","article-title":"Impact of non-alcoholic fatty liver disease on pregnancy","volume":"75","author":"Mousa","year":"2018","journal-title":"Br J Biomed Sci"},{"key":"10.1016\/j.bpobgyn.2020.02.011_bib44","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1016\/j.ebiom.2017.11.014","article-title":"Liver dysfunction during pregnancy and its association with preterm birth in China: a prospective cohort study","volume":"26","author":"Zhuang","year":"2017","journal-title":"EBioMedicine"},{"key":"10.1016\/j.bpobgyn.2020.02.011_bib45","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1089\/met.2017.0058","article-title":"Obstetric outcomes in women with nonalcoholic fatty liver disease","volume":"15","author":"Lee","year":"2017","journal-title":"Metab Syndr Relat Disord"},{"key":"10.1016\/j.bpobgyn.2020.02.011_bib46","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1016\/j.jhep.2018.09.013","article-title":"Longer lactation duration is associated with decreased prevalence of non-alcoholic fatty liver disease in women","volume":"70","author":"Ajmera","year":"2019","journal-title":"J\u00a0Hepatol"},{"key":"10.1016\/j.bpobgyn.2020.02.011_bib47","doi-asserted-by":"crossref","first-page":"658","DOI":"10.1038\/ajg.2016.57","article-title":"Gestational diabetes mellitus is strongly associated with non-alcoholic fatty liver disease","volume":"111","author":"Ajmera","year":"2016","journal-title":"Am J Gastroenterol"},{"key":"10.1016\/j.bpobgyn.2020.02.011_bib48","doi-asserted-by":"crossref","first-page":"641","DOI":"10.1007\/s00125-010-2009-0","article-title":"Increased prevalence of non-alcoholic fatty liver disease in European women with a history of gestational diabetes","volume":"54","author":"Forbes","year":"2011","journal-title":"Diabetologia"},{"key":"10.1016\/j.bpobgyn.2020.02.011_bib49","doi-asserted-by":"crossref","first-page":"109","DOI":"10.2337\/dc16-1017","article-title":"Nonalcoholic fatty liver disease is prevalent in women with prior gestational diabetes mellitus and independently associated with insulin resistance and waist circumference","volume":"40","author":"Foghsgaard","year":"2017","journal-title":"Diabetes Care"},{"key":"10.1016\/j.bpobgyn.2020.02.011_bib50","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1155\/2012\/725468","article-title":"Current treatment options for nonalcoholic fatty liver disease and nonalcoholic steatohepatitis","volume":"26","author":"Beaton","year":"2012","journal-title":"Can J Gastroenterol"}],"container-title":["Best Practice &amp; Research Clinical Obstetrics &amp; Gynaecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1521693420300390?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1521693420300390?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T17:11:22Z","timestamp":1761498682000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1521693420300390"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10]]},"references-count":50,"alternative-id":["S1521693420300390"],"URL":"https:\/\/doi.org\/10.1016\/j.bpobgyn.2020.02.011","relation":{},"ISSN":["1521-6934"],"issn-type":[{"value":"1521-6934","type":"print"}],"subject":[],"published":{"date-parts":[[2020,10]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Implications of abnormal liver function in pregnancy and non-alcoholic fatty liver disease","name":"articletitle","label":"Article Title"},{"value":"Best Practice & Research Clinical Obstetrics & Gynaecology","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.bpobgyn.2020.02.011","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2020 Published by Elsevier Ltd.","name":"copyright","label":"Copyright"}]}}