Intrahepatic cholestasis of pregnancy: maternal and fetal outcomes associated with elevated bile acid levels

Rezai, Shadi; Lam, Jason; Henderson, Cassandra E.

doi:10.1016/j.ajog.2015.03.040

Cited by 16 publications

(12 citation statements)

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“…A recent study reported that yeast supplementation to sows during gestation and lactation could improve the relative abundance of beneficial and fermentative bacteria ( Paraprevotella , Roseburia , and Eubacterium ) and inhibit the growth of pathogenic bacteria such as Proteobacteria in sows ( Hasan et al., 2018 ). In addition, studies have shown that gut microbiota impact significantly on the relative composition and abundance of bile acids across multiple body compartments, and an elevation of serum bile acids shows a significantly increased risk for intrauterine fetal death ( Geenes et al., 2014 , Rezai et al., 2015 , Swann et al., 2011 ). Tsai et al.…”

Section: Discussionmentioning

confidence: 99%

Live yeast supplementation during late gestation and lactation affects reproductive performance, colostrum and milk composition, blood biochemical and immunological parameters of sows

Xie

Bai

et al. 2020

Animal Nutrition

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This study was conducted to evaluate the effects of dietary live yeast (LY) supplementation during late gestation and lactation on reproductive performance, colostrum and milk composition, blood biochemical and immunological parameters of sows. A total of 40 multiparous sows were randomly fed either the control (CON) diet or the CON diet supplemented with LY at 1 g/kg from d 90 of gestation to weaning. Results showed that the number of stillborn piglets and low BW piglets were significantly decreased in the LY-supplemented sows compared with sows in the CON group ( P < 0.05). Moreover, the concentrations of protein, lactose and solids-not-fat were increased in the colostrum of LY-supplemented sows ( P < 0.05). Interestingly, the plasma activities of aspartate aminotransferase (AST), alkaline phosphatase (ALP), gamma-glutamyl transpeptidase (γ-GGT) at d 1 of lactation and alanine aminotransferase (ALT) at weaning day were decreased by feeding LY diet ( P < 0.05). Meanwhile, sows fed LY diet had higher plasma concentration of immunoglobulin G compared with sows fed CON diet at d 1 of lactation ( P < 0.05). In conclusion, LY supplementation in maternal diets decreased the number of stillborn piglets and low BW piglets, improved colostrum quality and health status of sows.

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Section: Discussionmentioning

confidence: 99%

Live yeast supplementation during late gestation and lactation affects reproductive performance, colostrum and milk composition, blood biochemical and immunological parameters of sows

Xie

Bai

et al. 2020

Animal Nutrition

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Section: Discussionmentioning

confidence: 99%

“…During pregnancy, the serum TBA of pregnant women showed a physiological increase due to the disturbance of bile acid transport in the liver caused by hormone changes [14]. Combined with clinical manifestations, ICP can be diagnosed when the TBA levels are higher than or equal to 10 µmol/L [14,34]. Studies have reported that ICP, which mainly manifested the increase of TBA levels in the liver and systemic circulation, would increase the risk of premature birth [13].…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, adverse perinatal outcomes are essential concerns in the eld of GDM. Epidemiological studies reported that the increase of TBA levels caused by cholestasis during pregnancy would increase the incidence of premature delivery, eclampsia, meconium-stained uid and stillbirth [13][14][15]. It was noteworthy that previous studies on TBA levels and adverse perinatal outcomes were only conducted in women with intrahepatic cholestasis of pregnancy (ICP).…”

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confidence: 99%

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Elevated Serum Total Bile Acid Level at Second Trimester Increases the Risk of Gestational Diabetes Mellitus and Adverse Perinatal Outcomes in Chinese Pregnant Women

Liu

Chen

et al. 2020

Preprint

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BackgroudBile acid metabolism is reported to be closely involved in glycolipid metabolism. We investigated the association of the total bile acid (TBA) levels at the second trimester with the risk of gestational diabetes mellitus (GDM) and adverse perinatal outcomes.MethodsWe performed a retrospective cohort study in 2773 Chinese pregnant women. Serum TBA level was measured by a biochemistry automatic analyzer. Logistic regression models with or without restricted cubic splines were performed.Results652 of 2773 pregnant women developed GDM. Women with GDM had higher serum TBA levels at the second trimester than that of healthy women (P < 0.001). Elevated serum TBA levels at the second trimester were associated with an increased risk of GDM in a dose-response manner. After the adjustment of age, BMI, smoking and drinking status, education background, lipid profiles, blood pressure, liver function, uric acid, bilirubin, urea nitrogen and creatinine, the odds ratios (ORs) of GDM for the highest (vs. the lowest) quartile were 1.83 (95% CI 1.10–3.38) in women. The inclusion of TBA levels at the second trimester in the model increased the area under the curve from 0.68 to 0.72 (95% CI: 0.68–0.76) (P < 0.05). Additionally, a higher serum TBA level was associated with higher odds of preterm birth (the highest quartile vs. the lowest quartile, AOR 1.91, 95% CI 1.26–2.98, P-trend = 0.017) and preeclampsia (the highest quartile vs. the lowest quartile, AOR 2.07, 95% CI 1.19–3.63, P-trend = 0.002). Furthermore, the U-shaped relationship was observed between TBA levels and the risk of premature rupture of membranes, with the lowest risk in the TBA concentration of 3.14 µmol/L.ConclusionWomen with higher fasting serum TBA levels at the second trimester have higher risk for development of GDM, preterm birth and preeclampsia.

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“…Estrogen-induced cholestasis (EIC) is one of the most common liver diseases, and mainly occurs during pregnancy, oral contraceptives or hormone replacement therapy (Rezai et al, 2015). EIC is characterized by dysfunction of bile acid (BA) homeostasis, leading to BA accumulation in the liver, thereby resulting in cholestatic liver injury, and poor fetal outcomes (Pusl and Beuers, 2007;Dong et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

Baicalin Protects Against 17α-Ethinylestradiol-Induced Cholestasis via the Sirtuin 1/Hepatic Nuclear Receptor-1α/Farnesoid X Receptor Pathway

Yang

Xiang

et al. 2020

Front. Pharmacol.

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Estrogen-induced cholestasis (EIC) is characterized by impairment of bile flow and accumulated bile acids (BAs) in the liver, always along with the liver damage. Baicalin is a major flavonoid component of Scutellaria baicalensis, and has been used in the treatment of liver diseases for many years. However, the role of baicalin in EIC remains to be elucidated. In this study, we demonstrated that baicalin showed obvious hepatoprotective effects in EIC rats by reducing serum biomarkers and increasing the bile flow rate, as well as by alleviating liver histology and restoring the abnormal composition of hepatic BAs. In addition, baicalin protected against estrogen-induced liver injury by up-regulation of the expression of hepatic efflux transporters and down-regulation of hepatic uptake transporters. Furthermore, baicalin increased the expression of hepatic BA synthase (CYP27A1) and metabolic enzymes (Bal, Baat, Sult2a1) in EIC rats. We showed that baicalin significantly inhibited hepatic inflammatory responses in EIC rats through reducing elevated levels of TNF-a, IL-1b, IL-6, and NF-kB. Finally, we confirmed that baicalin maintains hepatic BA homeostasis and alleviates inflammation through sirtuin 1 (Sirt1)/hepatic nuclear receptor-1a (HNF-1a)/ farnesoid X receptor (FXR) signaling pathway. Thus, baicalin protects against estrogeninduced cholestatic liver injury, and the underlying mechanism involved is related to activation of the Sirt1/HNF-1a/FXR signaling pathway.

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Intrahepatic cholestasis of pregnancy: maternal and fetal outcomes associated with elevated bile acid levels

Cited by 16 publications

References 2 publications

Live yeast supplementation during late gestation and lactation affects reproductive performance, colostrum and milk composition, blood biochemical and immunological parameters of sows

Live yeast supplementation during late gestation and lactation affects reproductive performance, colostrum and milk composition, blood biochemical and immunological parameters of sows

Elevated Serum Total Bile Acid Level at Second Trimester Increases the Risk of Gestational Diabetes Mellitus and Adverse Perinatal Outcomes in Chinese Pregnant Women

Baicalin Protects Against 17α-Ethinylestradiol-Induced Cholestasis via the Sirtuin 1/Hepatic Nuclear Receptor-1α/Farnesoid X Receptor Pathway

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