Open AccessIntrahepatic cholestasis of pregnancy and comorbidity: A 44‐year follow‐up study
Author(s) -
Hämäläinen SuviTuulia,
Turunen Kaisa,
Mattila Kari J.,
Kosunen Elise,
Sumanen Markku
Publication year - 2019
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.1111/aogs.13695
Subject(s) - medicine , cholestasis of pregnancy , odds ratio , pregnancy , comorbidity , obstetrics , population , cohort , confidence interval , cholestasis , gynecology , fetus , genetics , environmental health , biology
Abstract Introduction Intrahepatic cholestasis of pregnancy (ICP) is a reversible liver disorder occurring during pregnancy. It has a typical genetic background with known genetic mutations and can be considered an expression of this genetic predisposition. The objective of this study was to determine whether ICP is associated with specific long‐term comorbidity. Material and methods The study population comprised 571 women with ICP in at least one pregnancy who were compared with 1333 pregnant women without ICP during 1969‐1988 at Tampere University Hospital, Finland. The cohort's follow‐up time was 44 years. All ICD‐10 classification discharge diagnoses were examined for the women in the ICP group from 1998 to 2013 and ICD‐10 diagnoses from outpatient care from 1969 to 2013. Results At least one disease of the digestive system had been diagnosed in 50.4% (288/571) of the ICP mothers compared with 34.4% (459/1333) of the reference group ( P < 0.001). In a more detailed analysis, women with a history of ICP had an increased risk for cholelithiasis and/or cholecystitis (odds ratio [OR] 2.88, 95% confidence interval [CI] 2.17 to 3.84), diseases of the pancreas (OR 2.26, 95% CI 1.20 to 4.27) and hypothyroidism (OR 2.38, 95% CI 1.27 to 4.46) compared with the reference group. Arterial diseases were less common in the ICP mothers than in the reference group (OR 0.38, 95% CI .15 to .99). Regarding other diseases, there were no statistically significant differences between the ICP mothers and reference group. Conclusions Half of the women with a history of ICP were diagnosed with at least one disease of the digestive system compared with a third in the reference group. The risk of cholelithiasis, cholecystitis, diseases of the pancreas and hypothyroidism was increased compared with the reference group. These are important facts when counseling women after a pregnancy with ICP. Also, this is of importance for the general practitioners and other physicians who take care of these women.