Early- and Late-Onset Intrahepatic Cholestasis of Pregnancy: A Comparison of Maternal and Neonatal Outcomes

Abstract

Introduction: We investigated the maternal and neonatal outcomes of early- and late-onset intrahepatic cholestasis of pregnancy (ICP).

Methods: A total of 198 pregnant women were recruited into this retrospective cohort study. Women with ICP (n = 84) were classified into two groups: (1) Early-onset ICP (n = 36): pregnancy duration at diagnosis <34 weeks; (2) Late-onset ICP (n = 48): pregnancy duration at diagnosis ≥34 weeks. Maternal and neonatal outcomes were compared among the three groups.

Results: The assisted reproductive technology (ART) pregnancy rate and serum bile acid (SBA) levels were significantly higher in the early-onset ICP group with adverse perinatal outcome (APO) than those without. Notably, the birth weight was significantly lower among neonates in the early-onset group of ICP than among neonates in the late-onset ICP and control groups (p < 0.001). Birth weight (OR = 0.998, 95% CI: 0.997-0.999, p = 0.041)was associated with early-onset ICP, according to the multivariate analysis. Receiver-operating characteristic (ROC) analysis revealed that a cutoff value of 36.8 weeks for gestational age at diagnosis and 9.6 mmol/L for SBA can distinguish between ICP patients with APO and those without.

Discussion: Early-onset ICP is associated with low birth weight. ART pregnancies and women with higher SBA concentrations needed to be closely monitor for possible adverse perinatal outcomes in early-onset ICP.

Keywords: Pregnancy; adverse perinatal outcome; early-onset; intrahepatic cholestasis of pregnancy; late-onset.