FIRST-TRIMESTER GAMMA-GLUTAMYL TRANSFERASE AS AN INDEPENDENT PREDICTOR OF GESTATIONAL HYPERTENSION AND PREECLAMPSIA: A RETROSPECTIVE COHORT STUDY

Abstract

Background: Hypertensive disorders of pregnancy, including gestational hypertension (GHT) and preeclampsia (PE), remain leading causes of maternal and perinatal morbidity worldwide. Early identification of at-risk women is critical. Gamma-glutamyl transferase (GGT), a marker of hepatic oxidative stress and endothelial dysfunction, may reflect the pathophysiological substrate of placentation failure underlying hypertensive disorders. Its predictive value in the first trimester has not been thoroughly evaluated. Methods: This retrospective cohort study was conducted at Saveetha Medical College Hospital over a one-year period (January 2025 to January 2026) and included 150 singleton pregnancies with first-trimester serum GGT measurements (6 13 weeks of gestation). Participants were followed until delivery. Hypertensive outcomes were diagnosed according to ISSHP 2018 criteria. Logistic regression and ROC curve analyses were performed to assess independent predictive value. Results: Among 150 participants, 32 (21.3%) developed gestational hypertension and 20 (13.3%) developed preeclampsia; 98 (65.3%) remained normotensive. Mean first-trimester GGT was significantly higher in the GHT group (29.6 ± 6.1 U/L) and PE group (38.2 ± 7.8 U/L) compared to normotensive women (18.4 ± 4.2 U/L; p < 0.001). Elevated GGT was independently associated with hypertensive outcomes on multivariate analysis (adjusted OR 3.84; 95% CI 1.67–8.82; p = 0.002). ROC analysis demonstrated an AUC of 0.814, with sensitivity of 73.1% and specificity of 82.7% at a cut-off of 24.5 U/L. Conclusion: First-trimester serum GGT is a significant, independent predictor of gestational hypertension and preeclampsia. As a routinely available and inexpensive biomarker, GGT may enhance early risk stratification during antenatal care. Larger prospective studies are warranted to validate these findings.