Document Detail

Intrahepatic Cholestasis Of Pregnancy: Maternal and Fetal Outcomes Associated With Elevated Bile Acid Levels.
MedLine Citation:
PMID:  25046809     Owner:  NLM     Status:  Publisher    
OBJECTIVES: The primary aim of this study was to investigate the correlation between pregnancy outcome and bile acid (BA) levels in pregnancies affected by intrahepatic cholestasis of pregnancy (ICP). In addition, correlations between maternal and fetal BA levels were explored.
STUDY DESIGN: Retrospective study including women with pruritus and BA levels ≥10μmol/L, between January 2005 and August 2012, in three large hospitals in the Netherlands. The study group was divided in mild (10-39μmol/L), moderate (40-99μmol/L) and severe (≥100μmol/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 to the mild ICP group (p=<0.001). 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 significantly associated with spontaneous preterm birth (adjusted odds ratio 1.15, 95%CI; 1.03-1.28), meconium stained amniotic fluid (adjusted odds ratio 1.15, 95%CI; 1.06-1.25) and perinatal death (adjusted odds ratio 1.26, 95%CI; 1.01-1.57). Maternal BA levels at diagnosis and at delivery were positively correlated with umbilical cord blood BA levels (p=0.006 and p=0.012 respectively).
CONCLUSIONS: Severe ICP is associated with adverse pregnancy outcome. Levels of BA correlate between mother and fetus.
Laura Brouwers; Maria Ph Koster; Godelieve Cml Page-Christiaens; Hans Kemperman; Janine Boon; Inge M Evers; Auke Bogte; Martijn A Oudijk
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-7-18
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  -     ISSN:  1097-6868     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  2014 Jul 
Date Detail:
Created Date:  2014-7-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2014 Mosby, Inc. All rights reserved.
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