Peri-natal complications of intrahepatic cholestasis in pregnancy and association with bile acid levels
DOI:
https://doi.org/10.47489/szmc.v40i1.877Keywords:
intrahepatic cholestasis, pregnancy, still birth, neonatal respiratory distress syndromeAbstract
Background: Intrahepatic cholestasis of pregnancy (ICP) is most common pregnancy related disorder of liver, characterized by increase serum bile acid levels, associated with number of fetal complications e.g. preterm delivery, stillbirth, meconium-stained amniotic fluid and neonatal respiratory distress syndrome.
Objective: This study aimed to determine the frequency of perinatal complications of intra-hepatic cholestasis of pregnancy and its association with serum bile acids level.
Method: This prospective cohort study was conducted at Department of Gastroenterology, Fatima Memorial Hospital, Lahore in 2024-25. In this study, 129 pregnant patients with diagnosis of intrahepatic cholestasis of pregnancy were included. Serum bile acid levels were measured at admission. Clinical outcomes i.e. still birth, preterm delivery, neonatal respiratory distress syndrome and low birth weight were analyzed using statistical package for social sciences (SPSS) v26.
Results: In 129 patients, the mean age of the patients was 27.29±3.43 years, 94(72.9%) developed intrahepatic cholestasis of pregnancy during their first pregnancy. Most of the patients delivered via cesarean section (70.5%). Still birth was observed in 8(6.2%) cases and preterm delivery in 38 (29.5%). Neonatal respiratory distress syndrome, and low birth weight was seen in 23(17.8%) and 22(17.1%) newborns respectively. APGAR <7 at 1 min and 5min was noticed in 40 (31%) and 22(17.1%) respectively. Higher levels of serum bile acids were associated with increased risk of neonatal complications i.e. still birth (OR 1.476, CI 95 %, p-value 0.05) and preterm (OR 1.524, CI 95 %, p-value 0.00) in these patients.
Conclusion: This study showed that ICP had significant impact on the outcome of pregnancy, with higher levels of serum bile acid leading to increased risk of preterm baby, still birth and APGAR <7 at 1 min and 5 min.
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