Pregnancy outcomes and prognostic factors in patients with intrahepatic cholestasis of pregnancy

J Obstet Gynaecol. 2015 May;35(4):358-61. doi: 10.3109/01443615.2014.968102. Epub 2014 Nov 10.

Abstract

The aim of this study was to describe maternal and fetal characteristics associated with intrahepatic cholestasis of pregnancy (ICP) and to determine clinical and biochemical predictors of fetal complications. A total of 89 singleton pregnancies with ICP were analysed, retrospectively. All data concerning laboratory results, symptom onset time, treatment response, delivery time and infant information were recorded in the study protocol. The mean gestational age at diagnosis was 32.6 ± 3.4 weeks; mean time of delivery was 36.8 ± 1.9 weeks. Binary logistic regression revealed that gestational age at diagnosis was predictive of preterm delivery (OR = 2.3, 95% CI: 1.5-3.3, p = 0.001). The incidence of respiratory distress syndrome (RDS), fetal growth restriction, fetal distress and preterm delivery were significantly higher in patients who were diagnosed before 30 weeks than after 34 weeks' gestation (p < 0.01). Gestational age at diagnosis is an important independent factor predicting adverse perinatal outcomes in patients with ICP.

Keywords: Intrahepatic cholestasis; obstetrical outcome; ursodeoxycholic acid.

MeSH terms

  • Adult
  • Cholagogues and Choleretics / therapeutic use
  • Cholestasis, Intrahepatic* / complications
  • Cholestasis, Intrahepatic* / diagnosis
  • Cholestasis, Intrahepatic* / drug therapy
  • Cholestasis, Intrahepatic* / epidemiology
  • Female
  • Fetal Growth Retardation* / diagnosis
  • Fetal Growth Retardation* / epidemiology
  • Fetal Growth Retardation* / etiology
  • Gestational Age
  • Humans
  • Infant, Newborn
  • Pregnancy
  • Pregnancy Complications* / diagnosis
  • Pregnancy Complications* / drug therapy
  • Pregnancy Complications* / epidemiology
  • Pregnancy Outcome / epidemiology
  • Premature Birth* / diagnosis
  • Premature Birth* / epidemiology
  • Premature Birth* / etiology
  • Prognosis
  • Respiratory Distress Syndrome, Newborn* / diagnosis
  • Respiratory Distress Syndrome, Newborn* / epidemiology
  • Respiratory Distress Syndrome, Newborn* / etiology
  • Retrospective Studies
  • Risk Factors
  • Turkey / epidemiology
  • Ursodeoxycholic Acid / therapeutic use*

Substances

  • Cholagogues and Choleretics
  • Ursodeoxycholic Acid

Supplementary concepts

  • Intrahepatic Cholestasis of Pregnancy