Intrahepatic cholestasis of pregnancy and its association with preeclampsia and gestational diabetes: a retrospective analysis

Abstract

Intrahepatic cholestasis of pregnancy is the most common pregnancy-speci c liver disease. It occurs in approximately 1/1000 to 1/10000 of pregnancies and usually resolves during the postpartum period without causing any hepatic sequelae or mortality in the mother. This is a condition complicated by itching in the body, increased liver enzymes and fasting bile acid levels (≥ 10 µmol/L). Although the relationship of intrahepatic cholestasis (ICP) with Gestational Diabetes Mellitus (GDM) and preeclampsia has been evaluated in studies, there are few studies examining the relationship of intrahepatic cholestasis with GDM and preeclampsia. MethodsPatients who gave birth in our hospital between January 2018 and March 2022 were retrospectively reviewed from the hospital database and patient le records. Patients who were diagnosed with intrahepatic cholestasis and gave birth during the study period were retrospectively compared with all other patients who gave birth. ResultsIn our study, consistent with previous studies, we demonstrated a higher risk of GDM and pre-eclampsia in women with ICP compared to those without ICP. In our study, we observed a signi cant correlation between ICP and adverse perinatal outcomes. There was a statistically signi cant relation between the presence of ICP and spontaneous preterm delivery, iatrogenic preterm delivery, 5th minute Apgar score < 7 and presence of Neonatal Care Unit (NICU). On the other hand, no signi cant relationship was found between the presence of ICP and the presence of Small Gestational Age (SGA) and meconium. In our study, there was a signi cant relationship between the presence of ICP and mode of delivery, and the presence of postpartum hemorrhage (PPH) (p < 0.05). Those with ICP were found to have a lower gestational week and birth weight at birth, and a higher rate of caesarean delivery and PPH. ConclusionOur study suggested that patients with ICP had increased risk of development of GDM and preeclampsia. Take home messageOur study suggested that patients with ICP had increased risk of development of GDM and preeclampsia.Accordingly, we showed that it is associated with preterm birth and adverse perinatal outcomes.