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Aspartate Aminotransferase (AST, SGOT) — Pregnancy Reference Values

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Aspartate Aminotransferase (AST, SGOT) — Serum

Units Nonpregnant Adult 1st Trimester 2nd Trimester 3rd Trimester
U/L 12–38 3–23 3–33 4–32
µkat/L 0.2–0.63 0.05–0.38 0.05–0.55 0.07–0.53

AST typically remains within the low-normal nonpregnant range during pregnancy. Pregnancy does not raise AST; any elevation should prompt evaluation.

Normal changes during pregnancy
  • AST does not increase physiologically during pregnancy.
  • Mild decreases may reflect hemodilution or lower pyridoxine levels.
  • Any rise above normal should be considered abnormal and investigated.
Causes of HIGH AST (SGOT)

Pregnancy-specific liver disorders

  • Preeclampsia
  • HELLP syndrome
  • Acute fatty liver of pregnancy (AFLP)
  • Intrahepatic cholestasis of pregnancy
  • Hyperemesis gravidarum

Infections

  • Viral hepatitis (A, B, C, D, E)
  • EBV mononucleosis
  • CMV infection
  • Acute pyelonephritis
  • Sepsis

Hepatobiliary and metabolic diseases

  • Cholecystitis or biliary obstruction
  • Autoimmune hepatitis
  • Wilson disease
  • Hemochromatosis
  • Alpha-1 antitrypsin deficiency
  • Cirrhosis or acute liver failure

Drug-induced causes

  • Acetaminophen toxicity
  • Isoniazid
  • Methyldopa
  • Heparin
  • Methotrexate
  • Statins (if used prior to pregnancy)

Muscle injury

  • Myocardial infarction
  • Polymyositis / dermatomyositis
  • Trauma or crush injury
  • Surgery
  • Rhabdomyolysis
  • Malignant hyperthermia
  • Heat stroke

Other causes

  • Pulmonary embolism
  • Reye syndrome
  • Hemolysis
  • Toxic mushroom ingestion (e.g., Amanita)
  • Metastatic liver disease
  • Parasitic infections (e.g., trichinosis)
Causes of LOW AST
  • Vitamin B6 (pyridoxine) deficiency
  • Uremia
  • Severe chronic renal insufficiency
  • Metronidazole therapy
  • Mild reductions from late-pregnancy hemodilution

References

  1. Abbassi-Ghanavati M, Greer LG, Cunningham FG. Pregnancy and laboratory studies. Obstet Gynecol. 2009.
  2. Wallach J. Interpretation of Diagnostic Tests. 8th ed.
  3. Fischbach FT, Dunning MB. Manual of Laboratory & Diagnostic Tests. 7th ed.
  4. Wright JD, Sadovsky Y. Liver diseases in pregnancy.
  5. Campos J et al. Abnormal aminotransferases during acute pyelonephritis.