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Reference standard for serum bile acids in pregnancy.
MedLine Citation:
PMID:  22251417     Owner:  NLM     Status:  Publisher    
Please cite this paper as: Egan N, Bartels Ä, Khashan A, Broadhurst D, Joyce C, O'Mullane J, O'Donoghue K. Reference standard for serum bile acids in pregnancy. BJOG 2012;00:000-000. DOI: 10.1111/j.1471-0528.2011.03245.x. Objective  Obstetric cholestasis (OC) is a liver disorder characterised by pruritus and elevated serum bile acids (SBA) that affects one in 200 pregnant women. It is associated with adverse perinatal outcomes such as premature delivery and stillbirth. Mild OC is defined as SBA levels of 10-39 μmol/l, and severe OC is defined by levels >40 μmol/l. SBA levels in normal pregnancy have not been investigated. We aimed to establish reference values for SBA in healthy pregnant women across different trimesters of pregnancy. Design  Cross-sectional analysis of SBA levels. Setting  A large tertiary referral university teaching maternity hospital. Population  Healthy pregnant women with a singleton pregnancy and a body mass index (BMI) < 40, excluding women with significant alcohol intake, history of liver disease, prior cholecystectomy and OC. Methods  Cross-sectional analysis of SBA levels at 12, 20, 28 and 36 weeks of gestation, and on days 1-3 postpartum. Main outcome measures  SBA levels in μmol/l. Results  A total of 219 women attending for antenatal care were recruited, and SBA levels were assayed at 12, 20, 28 and 36 weeks of gestation, and up to 72 hours postpartum (n = 44-49 cases at each stage). The majority were white European women, with a median age of 30 years (range 17-46 years) and median BMI of 25 (range 18-38). Values of SBA ranged from 0.3 to 9.8 μmol/l in 216 women, with only three measurements outside this range. There were no significant changes throughout pregnancy. Conclusions  SBA values in uncomplicated pregnancies are consistent, regardless of gestation, and are not elevated in pregnancy. The current reference values for the diagnosis of OC appear to be appropriate.
N Egan; A Bartels; As Khashan; DI Broadhurst; C Joyce; J O'Mullane; K O'Donoghue
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-1-18
Journal Detail:
Title:  BJOG : an international journal of obstetrics and gynaecology     Volume:  -     ISSN:  1471-0528     ISO Abbreviation:  -     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-1-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100935741     Medline TA:  BJOG     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2012 RCOG.
Anu Research Centre, Department of Obstetrics and Gynaecology, University College Cork, Cork University Maternity Hospital, Cork, Ireland Department of Medicine, University of Alberta, Edmonton, Alberta, Canada Department of Biochemistry, Cork University Hospital, Cork, Ireland.
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