TY - JOUR
T1 - The prevalence and pregnancy outcomes of intrahepatic cholestasis of pregnancy
T2 - A retrospective clinical audit review
AU - Gardiner, Fergus W.
AU - McCuaig, Ruth
AU - Arthur, Chris
AU - Carins, Thomas
AU - Morton, Adam
AU - Laurie, Josephine
AU - Neeman, Teresa
AU - Lim, Boon
AU - Peek, Michael J.
N1 - Publisher Copyright:
© The Author(s) 2018.
PY - 2019/9/1
Y1 - 2019/9/1
N2 - Background: To determine the prevalence and outcomes of intrahepatic cholestasis of pregnancy. Methods: A review comparing intrahepatic cholestasis of pregnancy pregnancies to all other pregnancies in three tertiary care Australian hospitals over a 36-month period. Results: There were 43,876 pregnancies. The prevalence of intrahepatic cholestasis of pregnancies (n = 319) was 0.7%. There were differences between intrahepatic cholestasis of pregnancy and non-intrahepatic cholestasis of pregnancy mothers including higher prevalence of South Asian (22.6% versus 3.1%, p < 0.001), Indigenous Australian (3.8% versus 1.8%, p < 0.05), and Asian ethnicity (8.4% versus 5.7%, p < 0.05), mothers with a body mass index >35 kg/m2 (10.6% versus 5.5%, p < 0.001), those with diabetes mellitus (25.7% versus 9.8%, p < 0.001), and those with twin births (8.7% versus 2.2%, p < 0.001). The primary clinical outcomes of intrahepatic cholestasis of pregnancy included a median gestational age at delivery of 36.4 (SE 0.09) weeks compared to 38.6 (SE 0.01) weeks (p < 0.001), a lower birth weight (3.12 (SE 0.03) versus 3.31 kg (SE 0.03), p < 0.001), and an increase in special care nursery admissions (44.5% versus 15.3%, p < 0.001). Conclusion: Treated intrahepatic cholestasis of pregnancy in the population described here had similar mortality outcomes although increased special care nursery admission as compared to the general population.
AB - Background: To determine the prevalence and outcomes of intrahepatic cholestasis of pregnancy. Methods: A review comparing intrahepatic cholestasis of pregnancy pregnancies to all other pregnancies in three tertiary care Australian hospitals over a 36-month period. Results: There were 43,876 pregnancies. The prevalence of intrahepatic cholestasis of pregnancies (n = 319) was 0.7%. There were differences between intrahepatic cholestasis of pregnancy and non-intrahepatic cholestasis of pregnancy mothers including higher prevalence of South Asian (22.6% versus 3.1%, p < 0.001), Indigenous Australian (3.8% versus 1.8%, p < 0.05), and Asian ethnicity (8.4% versus 5.7%, p < 0.05), mothers with a body mass index >35 kg/m2 (10.6% versus 5.5%, p < 0.001), those with diabetes mellitus (25.7% versus 9.8%, p < 0.001), and those with twin births (8.7% versus 2.2%, p < 0.001). The primary clinical outcomes of intrahepatic cholestasis of pregnancy included a median gestational age at delivery of 36.4 (SE 0.09) weeks compared to 38.6 (SE 0.01) weeks (p < 0.001), a lower birth weight (3.12 (SE 0.03) versus 3.31 kg (SE 0.03), p < 0.001), and an increase in special care nursery admissions (44.5% versus 15.3%, p < 0.001). Conclusion: Treated intrahepatic cholestasis of pregnancy in the population described here had similar mortality outcomes although increased special care nursery admission as compared to the general population.
KW - Intrahepatic cholestasis of pregnancy
KW - liver function tests
KW - obstetric cholestasis
KW - pruritus
KW - ursodeoxycholic acid
UR - http://www.scopus.com/inward/record.url?scp=85058672425&partnerID=8YFLogxK
U2 - 10.1177/1753495X18797749
DO - 10.1177/1753495X18797749
M3 - Article
SN - 1753-495X
VL - 12
SP - 123
EP - 128
JO - Obstetric Medicine
JF - Obstetric Medicine
IS - 3
ER -