Predictors of adverse perinatal outcomes in intrahepatic cholestasis of pregnancy

Abstract

Objectives: Our objective was to evaluate in our clinic the perinatal outcomes of patients diagnosed with ICP based on pre-treatment maternal serum bile acid levels, attempt to identify the risk group and review the literature in light of this information. Material and methods: In total, 370 patients diagnosed with ICP were included in the study, divided into two groups based on the fasting total serum bile acid level before UDCA (Group 1: 10 >= 40 mu mol/L, and Group 2: >= 40 mu mol/L). The groups were examined for clinical characteristics and pregnancy outcomes. Results: It was found that preterm delivery and neonatal intensive care need increased at a serum bile acid cut-off value of 34 mu mol/L. Regardless of serum bile acid, significantly higher rates of meconium-stained amniotic fluid and foetal distress were observed in patients whose diagnoses were made before 34 weeks of gestation. Conclusions: Foetal complications over 40 mu mol/L of serum bile acid were significantly increased. However, slightly lower levels cut-off values (34 mu mol/L) were obtained in terms of preterm birth and neonatal intensive care need. The incidence of meconium-stained amniotic fluid and foetal distress was higher in patients whose diagnosis were made before 34 weeks of gestation.