{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T15:26:52Z","timestamp":1784042812727,"version":"3.55.0"},"reference-count":47,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2017,6,22]],"date-time":"2017-06-22T00:00:00Z","timestamp":1498089600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2017,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aim<\/jats:title><jats:p>Liver dysfunction with decreased antithrombin (AT) activity and\/or thrombocytopenia is life threatening in pregnant women. Whether AT is clinically useful for prediction of liver dysfunction remains unclear.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 541 women were registered prospectively at gestational week 34.7 (20.0\u201341.4) with available data on antenatal AT and platelet count (PLC).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Liver dysfunction defined as serum aspartate aminotransferase\u00a0&gt;\u00a045\u00a0IU\/L concomitant with lactate dehydrogenase\u00a0&gt;\u00a0400\u00a0IU\/L occurred in five women antenatally (\u2264\u00a02\u00a0weeks before delivery) and in 17 women post\u2010partum (within 1\u00a0week post\u2010partum). Median (5th\u201395th) antenatal value was 85 (62\u2013110)% for AT and 202 (118\u2013315)\u00a0\u00d7\u00a010<jats:sup>9<\/jats:sup>\/L for PLC in the 541 women and was significantly lower in women with than without perinatal liver dysfunction; 75 (51\u2013108) <jats:italic>versus<\/jats:italic> 86 (62\u2013110)% and 179 (56\u2013244) <jats:italic>versus<\/jats:italic> 203 (121\u2013316)\u00a0\u00d7\u00a010<jats:sup>9<\/jats:sup>\/L, respectively. Nineteen (86%) women with liver dysfunction showed AT\u00a0\u2264\u00a062% or thrombocytopenia (PLC\u00a0\u2264\u00a0118\u00a0\u00d7\u00a010<jats:sup>9<\/jats:sup>\/L) perinatally, but five lacked thrombocytopenia throughout the perinatal period. The best cut\u2010off (AT, 77%; PLC, 139\u00a0\u00d7\u00a010<jats:sup>9<\/jats:sup>\/L) suggested by receiver operating characteristic curve gave antenatal AT and PLC sensitivity of 59% and 41% with positive predictive value of 8.6% and 14%, respectively, and combined use of AT and PLC improved sensitivity to 73% (16\/22) with positive predictive value of 9.2% for prediction of perinatal liver dysfunction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Reduced AT not accompanied by thrombocytopenia can precede liver dysfunction. Clinical introduction of AT may enhance the safety of pregnant women.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jgh.13714","type":"journal-article","created":{"date-parts":[[2016,12,25]],"date-time":"2016-12-25T05:24:32Z","timestamp":1482643472000},"page":"1378-1386","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Association of antenatal antithrombin activity with perinatal liver dysfunction: A prospective multicenter study"],"prefix":"10.1111","volume":"32","author":[{"given":"Mamoru","family":"Morikawa","sequence":"first","affiliation":[{"name":"Department of Obstetrics Hokkaido University Hospital  Sapporo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirotada","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Jichi Medical University Hospital  Shimotsuke Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mana","family":"Obata\u2010Yasuoka","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Tsukuba Hospital  Tsukuba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michi","family":"Kasai","sequence":"additional","affiliation":[{"name":"Perinatal Center for Maternity and Neonate Yokohama City University Medical Center  Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroaki","family":"Itoh","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Hamamatsu University Hospital  Hamamatsu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akihide","family":"Ohkuchi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Jichi Medical University Hospital  Shimotsuke Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0560-7034","authenticated-orcid":false,"given":"Hiromi","family":"Hamada","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Tsukuba Hospital  Tsukuba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shigeru","family":"Aoki","sequence":"additional","affiliation":[{"name":"Perinatal Center for Maternity and Neonate Yokohama City University Medical Center  Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naohiro","family":"Kanayama","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Hamamatsu University Hospital  Hamamatsu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hisanori","family":"Minakami","sequence":"additional","affiliation":[{"name":"Department of Obstetrics Hokkaido University Hospital  Sapporo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,6,22]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.51.6.876"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2008-1040563"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2008.148676"},{"key":"e_1_2_6_5_1","first-page":"4(9)","article-title":"Beyond maternal death: improving the quality of maternal care through national studies of \u2018near\u2010miss\u2019 maternal morbidity","author":"Knight M","year":"2016","journal-title":"Programme Grants Appl. 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