TY - JOUR
T1 - Intrahepatic cholestasis of pregnancy: maternal and fetal outcomes associated with elevated bile acid levels
AU - Brouwers, Laura
AU - Koster, Maria P. H.
AU - Page-Christiaens, Godelieve C. M. L.
AU - Kemperman, Hans
AU - Boon, Janine
AU - Evers, Inge M.
AU - Bogte, Auke
AU - Oudijk, Martijn A.
PY - 2015
Y1 - 2015
N2 - OBJECTIVE: The primary aim of this study was to investigate the correlation between pregnancy outcome and bile acid (BA) levels in pregnancies that were affected by intrahepatic cholestasis of pregnancy (ICP). In addition, correlations between maternal and fetal BA levels were explored. STUDY DESIGN: We conducted a retrospective study that included women with pruritus and BA levels >= 10 mu mol/L between January 2005 and August 2012 in 3 large hospitals in the Netherlands. The study group was divided in mild (10-39 mu mol/L), moderate (40-99 mu mol/L), and severe (>= 100 mu mol/L) ICP. Main outcome measures were spontaneous preterm birth, meconium-stained amniotic fluid, asphyxia, and perinatal death. Univariate and multivariate logistic regression analysis was used to study associations between BA levels and adverse outcome. RESULTS: A total of 215 women were included. Gestational age at diagnosis and gestational age at delivery were significantly lower in the severe, as compared with the mild, ICP group (P <.001). Spontaneous preterm birth (19.0%), meconium-stained fluid (47.6%), and perinatal death (9.5%) occurred significantly more often in cases with severe ICP. Higher BA levels were associated significantly with spontaneous preterm birth (adjusted odds ratio [aOR], 1.15; 95% confidence interval [CI], 1.03-1.28), meconium-stained amniotic fluid (aOR, 1.15; 95% CI, 1.06-1.25), and perinatal death (aOR, 1.26; 95% CI, 1.01-1.57). Maternal BA levels at diagnosis and at delivery were correlated positively with umbilical cord blood BA levels (P = .006 and .012, respectively). CONCLUSION: Severe ICP is associated with adverse pregnancy outcome. Levels of BA correlate between mother and fetus
AB - OBJECTIVE: The primary aim of this study was to investigate the correlation between pregnancy outcome and bile acid (BA) levels in pregnancies that were affected by intrahepatic cholestasis of pregnancy (ICP). In addition, correlations between maternal and fetal BA levels were explored. STUDY DESIGN: We conducted a retrospective study that included women with pruritus and BA levels >= 10 mu mol/L between January 2005 and August 2012 in 3 large hospitals in the Netherlands. The study group was divided in mild (10-39 mu mol/L), moderate (40-99 mu mol/L), and severe (>= 100 mu mol/L) ICP. Main outcome measures were spontaneous preterm birth, meconium-stained amniotic fluid, asphyxia, and perinatal death. Univariate and multivariate logistic regression analysis was used to study associations between BA levels and adverse outcome. RESULTS: A total of 215 women were included. Gestational age at diagnosis and gestational age at delivery were significantly lower in the severe, as compared with the mild, ICP group (P <.001). Spontaneous preterm birth (19.0%), meconium-stained fluid (47.6%), and perinatal death (9.5%) occurred significantly more often in cases with severe ICP. Higher BA levels were associated significantly with spontaneous preterm birth (adjusted odds ratio [aOR], 1.15; 95% confidence interval [CI], 1.03-1.28), meconium-stained amniotic fluid (aOR, 1.15; 95% CI, 1.06-1.25), and perinatal death (aOR, 1.26; 95% CI, 1.01-1.57). Maternal BA levels at diagnosis and at delivery were correlated positively with umbilical cord blood BA levels (P = .006 and .012, respectively). CONCLUSION: Severe ICP is associated with adverse pregnancy outcome. Levels of BA correlate between mother and fetus
U2 - https://doi.org/10.1016/j.ajog.2014.07.026
DO - https://doi.org/10.1016/j.ajog.2014.07.026
M3 - Article
C2 - 25046809
SN - 0002-9378
VL - 212
SP - 100.e1-100.e7
JO - American Journal of Obstetrics and Gynecology
JF - American Journal of Obstetrics and Gynecology
IS - 1
ER -