Evaluation of serum Glutathione-S Transferase-Alpha as a Biomarker of Intrahepatic Cholestasis of Pregnancy.

OBJECTIVE: To evaluate if serum Glutathione-S Transferase-Alpha (GSTA) can be used as a biomarker of intrahepatic cholestasis of pregnancy (IHCP). METHODS: 45 pregnant women with IHCP and 45 age and weight matched pregnant women as controls were enrolled and liver function tests including serum GSTA were measured. All cases and controls were followed for their maternal and foetal outcomes till delivery. Statistical analysis included unpaired t test, Mann-Whitney test and chi square test. RESULTS: IHCP group showed higher mean serum GSTA concentrations compared to controls (85.6 ± 42.7 mcg/l vs. 40.6 ± 6.8 mcg/l; p < 0.001, CI 95%). A positive correlation was observed between serum GSTA and other markers of IHCP like serum bilirubin (r=0.346; p< 0.001), AST (r=0.708; p< 0.001), ALT (r=0.656; p< 0.001) and bile acids (r= 0.491; p< 0.001).Cut off value for GSTA of 47 mcg/l demonstrated good sensitivity (97.8%),specificity (88.9%), positive predictive value (89.8%) and accuracy (93.3%) to diagnose IHCP. CONCLUSION: Serum GSTA may be a new promising, diagnostic tool with good accuracy compared to the routine markers for diagnosing IHCP.