IMR Press / CEOG / Volume 48 / Issue 6 / DOI: 10.31083/j.ceog4806220
Open Access Original Research
Normal distribution of alkaline phosphatase levels during pregnancy
Show Less
1 Sackler Faculty of Medicine, Tel Aviv University, 69978 Tel Aviv, Israel
2 Department of Obstetrics and Gynecology, Meir Medical Center, 4428164 Kfar Saba, Israel
3 Helen Schneider Hospital for Women, Rabin Medical Center, 4941492 Petach Tikva, Israel
4 The Liver Institute, Rabin Medical Center, 4941492 Petach Tikva, Israel
*Correspondence: eranh42@gmail.com (Eran Hadar)
Clin. Exp. Obstet. Gynecol. 2021, 48(6), 1393–1399; https://doi.org/10.31083/j.ceog4806220
Submitted: 8 February 2021 | Revised: 27 July 2021 | Accepted: 28 July 2021 | Published: 15 December 2021
Copyright: © 2021 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license (https://creativecommons.org/licenses/by/4.0/).
Abstract

Background: Previous small-scale studies have reported alkaline phosphatase (ALP) distribution throughout gestation. This retrospective, observational analysis aimed to establish a large-scale, week-specific nomogram of total ALP during pregnancy, and to address physiological parameters that may impact normal ALP secretion throughout pregnancy. Methods: We analyzed ALP levels during pregnancy among 5285 healthy women from various ethnicities, with uncomplicated, term, singleton gestations, who delivered in a single tertiary medical center, from August 2007 to December 2012. Results: We found that normal gestational ALP is significantly elevated during pregnancy compared to a non-pregnant state (132.2 ± 3.0 IU/L vs. 116.7 ± 2.3 IU/L, p < 0.001), and during the third and second trimesters compared to the first trimester (166.4 ± 1.66, 123.7 ± 2.4 and 95.7 ± 1.6 IU/L, respectively; p < 0.001). ALP levels remained unaffected by the modifiers we explored: neonatal sex, neonatal birthweight and maternal age. Conclusion: ALP levels during pregnancy are higher than in the non-pregnant state, gradually increase from the end of the first trimester to term, peaking just prior to delivery. The nomogram presented here can serve as the basis for comparison between a normal population and those with various pregnancy complications, to determine how ALP is associated with adverse pregnancy outcomes.

Keywords
Alkaline phosphatase
Distribution
Female
Nomogram
Pregnancy
Figures
Fig. 1.
Share
Back to top