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Risk factors for adverse fetal outcomes among women with early‐ versus late‐onset intrahepatic cholestasis of pregnancy
Author(s) -
Jin Jin,
Pan Shilei,
Huang Liping,
Yu Yanhong,
Zhong Mei,
Zhang Guowei
Publication year - 2015
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2014.09.013
Subject(s) - medicine , cholestasis of pregnancy , group b , cholestasis , alkaline phosphatase , pregnancy , bile acid , fetus , risk factor , group a , gastroenterology , adverse effect , obstetrics , biochemistry , genetics , chemistry , biology , enzyme
Objective To determine risk factors for adverse fetal outcomes (AFOs) among women with intrahepatic cholestasis of pregnancy (ICP) on the basis of time of onset. Methods In a retrospective analysis, data were obtained for all women with ICP admitted to two centers in Guangzhou, China, between February 1, 1993, and January 31, 2014. Patients were divided into group A (early‐onset ICP) and group B (late‐onset ICP), and were further divided on the basis of severity. The frequency of AFOs was assessed. Results Among 371 eligible women, 57 (15.4%) were in group A and 314 (84.6%) in group B. AFOs affected 20 (35.1%) women in group A and 67 (21.3%) in group B ( P = 0.024), and 12 (54.5%) of 22 women in group A and 21 (29.6%) of 71 in group B with severe ICP ( P = 0.032). Independent risk factors for AFO in group A were increased levels of serum bile acid ( P = 0.016) and alkaline phosphatase ( P = 0.004). Independent risk factors in group B were increased levels of alkaline phosphatase ( P < 0.001) and gamma‐glutamyl transpeptidase ( P = 0.001). Conclusion Early‐onset ICP is associated with a higher frequency of AFO than is late‐onset ICP, especially in severe disease. The risk factors differ between early‐onset and late‐onset ICP.