Predictors of adverse perinatal outcomes in intrahepatic cholestasis of pregnancy

Ginekol Pol. 2019;90(4):217-222. doi: 10.5603/GP.2019.0039.

Abstract

Objectives: Our objective was to evaluate in our clinic the perinatal outcomes of patients diagnosed with ICP based on pre-treatment maternal serum bile acid levels, attempt to identify the risk group and review the literature in light of this information.

Material and methods: In total, 370 patients diagnosed with ICP were included in the study, divided into two groups based on the fasting total serum bile acid level before UDCA (Group 1: 10 ≥ 40 μmol/L, and Group 2: ≥ 40 μmol/L). The groups were examined for clinical characteristics and pregnancy outcomes.

Results: It was found that preterm delivery and neonatal intensive care need increased at a serum bile acid cut-off value of 34 μmol/L. Regardless of serum bile acid, significantly higher rates of meconium-stained amniotic fluid and foetal distress were observed in patients whose diagnoses were made before 34 weeks of gestation.

Conclusions: Foetal complications over 40 μmol/L of serum bile acid were significantly increased. However, slightly lower levels cut-off values (34 μmol/L) were obtained in terms of preterm birth and neonatal intensive care need. The incidence of meconium-stained amniotic fluid and foetal distress was higher in patients whose diagnosis were made before 34 weeks of gestation.

Keywords: intrahepatic cholestasis; perinatal complications; pregnancy.

MeSH terms

  • Adult
  • Bile Acids and Salts / blood
  • Cholestasis, Intrahepatic / epidemiology*
  • Female
  • Humans
  • Pregnancy
  • Pregnancy Complications / epidemiology*
  • Pregnancy Outcome / epidemiology*
  • ROC Curve
  • Retrospective Studies
  • Risk Factors
  • Young Adult

Substances

  • Bile Acids and Salts

Supplementary concepts

  • Intrahepatic Cholestasis of Pregnancy