Laura Brouwers1, Maria P H Koster1, Godelieve C M L Page-Christiaens1, Hans Kemperman2, Janine Boon3, Inge M Evers4, Auke Bogte5, Martijn A Oudijk6. 1. Department of Obstetrics, University Medical Center Utrecht, Utrecht, the Netherlands. 2. Department of Clinical Chemistry and Hematology Laboratory, University Medical Center Utrecht, Utrecht, the Netherlands. 3. Department of Obstetrics and Gynecology, Diakonessenhuis, Utrecht, the Netherlands. 4. Department of Obstetrics and Gynecology, Meander Medical Center, Amersfoort, the Netherlands. 5. Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, the Netherlands. 6. Department of Obstetrics, University Medical Center Utrecht, Utrecht, the Netherlands. Electronic address: m.a.oudijk-3@umcutrecht.nl.
Abstract
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 μmol/L between January 2005 and August 2012 in 3 large hospitals in the Netherlands. The study group was divided in mild (10-39 μmol/L), moderate (40-99 μmol/L), and severe (≥100 μmol/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.
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 μmol/L between January 2005 and August 2012 in 3 large hospitals in the Netherlands. The study group was divided in mild (10-39 μmol/L), moderate (40-99 μmol/L), and severe (≥100 μmol/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.
Authors: Tetsuya Kawakita; Laura I Parikh; Patrick S Ramsey; Chun-Chih Huang; Alexander Zeymo; Miguel Fernandez; Samuel Smith; Sara N Iqbal Journal: Am J Obstet Gynecol Date: 2015-06-10 Impact factor: 8.661
Authors: Sven Kehl; Irene Hösli; Ulrich Pecks; Philipp Reif; Ralf L Schild; Markus Schmidt; Dagmar Schmitz; Christiane Schwarz; Daniel Surbek; Michael Abou-Dakn Journal: Geburtshilfe Frauenheilkd Date: 2021-08-09 Impact factor: 2.754