Intrahepatic cholestasis of pregnancy and its association with preeclampsia and gestational diabetes: a retrospective analysis

Huseyin Aytug Avsar; Ufuk Atlıhan; Can Ata; Selcuk Erkılınc

doi:10.1007/s00404-024-07507-0

Intrahepatic cholestasis of pregnancy and its association with preeclampsia and gestational diabetes: a retrospective analysis

Arch Gynecol Obstet. 2024 Apr 16. doi: 10.1007/s00404-024-07507-0. Online ahead of print.

Authors

Huseyin Aytug Avsar¹, Ufuk Atlıhan², Can Ata³, Selcuk Erkılınc¹

Affiliations

¹ Department of Obstetrics and Gynecology, Izmir Demokrasi University, Buca Seyfi Demirsoy Training and Research Hospital, Izmir, Turkey.
² Private Karataş Hospital, Izmir, Turkey.
³ Department of Obstetrics and Gynecology, Izmir Demokrasi University, Buca Seyfi Demirsoy Training and Research Hospital, Izmir, Turkey. drcanata@yahoo.com.

PMID: 38625544
DOI: 10.1007/s00404-024-07507-0

Abstract

Purpose: To evaluate maternal and neonatal outcomes in patients with intrahepatic cholestasis of pregnancy (ICP).

Methods: Patients who gave birth in our hospital between January 2018 and March 2022 were retrospectively reviewed from the hospital database and patient file records. The study comprised 1686 patients, 54 in the ICP group and 1632 controls. Patients who had ICP after 20 weeks of gestation and were monitored and delivered at our facility were enrolled. Maternal demographic and obstetric characteristics data were examined. Perinatal outcomes were also assessed. Logistic regression analysis was used to determine adverse maternal outcomes.

Results: The mean age was 29 years. ART, GDM, and preeclampsia were significantly higher in the ICP group. The mean serum bile acid level was 19.3 ± 3 μmol/L in the ICP group. There was a higher risk of GDM and pre-eclampsia in women with ICP compared with those without and a significant association between ICP and adverse perinatal outcomes. There was a statistically significant relation between the presence of ICP and spontaneous preterm delivery, iatrogenic preterm delivery, 5th-minute Apgar scores < 7, and NICU requirement. No significant relationship was found between the presence of ICP and SGA and meconium. There was a significant relationship between the presence of ICP, mode of delivery, and PPH (p < 0.05). Those with ICP had a lower gestational week and birth weight, and higher rates of cesarean delivery and PPH.

Conclusion: ICP should prompt close monitoring and management to mitigate the potential exacerbation of adverse outcomes, including preeclampsia, GDM, and preterm birth.

Keywords: Bile acid; Gestational diabetes mellitus; Intrahepatic cholestasis of pregnancy; Preeclampsia.