Effects of intrahepatic cholestasis of pregnancy on hepatic function, changes of inflammatory cytokines and fetal outcomes

Abstract

The effects of intrahepatic cholestasis of pregnancy (ICP) on hepatic function, changes of inflammatory cytokines and fetal outcomes were studied. In total, 663 pregnant women admitted to Daqing Longnan Hospital from July 2016 to December 2017 were selected. There were, 40 cases with ICP enrolled in the observation group, and 40 normal pregnant women were recruited in the normal group. They were also grouped according to hepatic function and inflammatory cytokines, with 40 cases in each group. Neonatal Apgar scores were recorded. The correlations of serum cholylglycine (CG) in pregnant women with umbilical artery systolic-to-diastolic (S/D) ratio in the third trimester of pregnancy, the alanine aminotransferase level, the high-sensitivity C-reactive protein (hs-CRP) level, neonatal Apgar score and gestational week were analyzed. The birth weight in the observation group was lighter than that in the normal group (P<0.05); the gestational week at birth was earlier than that in the normal group (P<0.05); Apgar score at birth was lower than that in the normal group (P<0.05), and the levels of inflammatory cytokines were higher than those in the control group (P<0.05). Apgar scores of newborns at birth and at 1 and 5 min after birth in the normal hepatic function and normal inflammatory cytokine groups were higher than those in the abnormal hepatic function group (P<0.05). The serum CG level in pregnant women was positively correlated with umbilical artery S/D ratio, the alanine aminotransferase level and the hs-CRP level in the third trimester of pregnancy, but negatively correlated with neonatal Apgar score and gestational week. Among patients with ICP, the higher the GG level in the body is, the higher the alanine aminotransferase, inflammatory cytokine and umbilical artery S/D ratio will be, which may cause lower neonatal Apgar score, neonatal asphyxia and premature delivery.

Value of Serum Glycocholic Acid and Total Bile Acids in Predicting Maternal and Perinatal Outcomes in Intrahepatic Cholestasis of Pregnancy

“…The maternal placental villi exhibit a dependent contraction response in the presence of elevated bile acid levels, resulting in acute ischemia and hypoxic symptoms. Excess CG in the blood also influences the cellular oxidative phosphorylation process, resulting in a reduction in the efficiency of fetal ATP application and, as a result, a higher risk of poor fetal outcome [ 23 , 24 ]. The findings of this paper's grouping and intergroup comparisons based on CG and TBA levels support this hypothesis, indicating that more fantastic CG and TBA levels are linked to a higher risk of poor newborn outcomes.…”

SARS-CoV-2 Infection and Inflammatory Response in a Twin Pregnancy

“…First, the mother was reported to have mild cholestasis of pregnancy, a condition associated with higher values of TNFa, IL1b, and Il-6 in the sera, and lower values of IL-4 and IL-10 [ 31 , 32 ]. Although expected, these current findings are counterbalanced by downregulation of IFNγ expression, which is reported as a hallmark of the antiviral response even in SARS-CoV-2 infection [ 33 ], being higher in pregnancy cholestasis [ 31 ] and more significant in patients infected with SARS-CoV-2 [ 34 ], as suggested in other reports [ 24 , 35 ]. On the other hand, IFNγ expression, along with IFN-α and IL-2 has been shown to be lower during influenza epidemic in pregnant women, when compared with nonpregnant women [ 36 ].…”

Dysregulated Hepatic Expression of Glucose Transporter Type-1, Toll-Like Receptor 4, and Nuclear Factor Kappa B in Estrogen-Induced Cholestasis Pregnant Rats with Placental Ischemia-Reperfusion Stress

“…1,3,5 During pregnancy, the liver and placenta are closely related to each other for bile acid transportation, immune activities, and metabolism. Wang et al 23 analyzed the correlations of maternal serum cholylglycine with umbilical artery systolic-to-diastolic ratio in ICP. They concluded that the maternal serum cholylglycine levels were positively correlated with umbilical artery systolic-to-diastolic ratio.…”