| Title: | Evaluating the effect of bile acid levels on maternal and perinatal outcomes in intrahepatic cholestasis of pregnancy : a retrospective study |
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| Authors: | ID Gregorc, Petra (Author)
ID Verdenik, Ivan (Author)
ID Pečlin, Polona (Author) |
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| Files: |  PDF - Presentation file, download (904,74 KB)
MD5: 0FAF6AEADDCAEE326C8E2FBCB7AA0F90
 URL - Source URL, visit https://www.mdpi.com/2075-4418/15/17/2185
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| Language: | English |
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| Typology: | 1.01 - Original Scientific Article |
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| Organization: |  UKC LJ - Ljubljana University Medical Centre
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| Abstract: | first_pagesettingsOrder Article Reprints Open AccessArticle Evaluating the Effect of Bile Acid Levels on Maternal and Perinatal Outcomes in Intrahepatic Cholestasis of Pregnancy: A Retrospective Study by Petra Gregorc 1,Ivan Verdenik 1ORCID andPolona Pečlin 1,2,*ORCID 1 Division of Obstetrics and Gynaecology, Department of Perinatology, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia 2 Department of Gynaecology and Obstetrics, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia * Author to whom correspondence should be addressed. Diagnostics 2025, 15(17), 2185; https://doi.org/10.3390/diagnostics15172185 (registering DOI) Submission received: 14 July 2025 / Revised: 21 August 2025 / Accepted: 22 August 2025 / Published: 28 August 2025 (This article belongs to the Special Issue Diagnosis and Prognosis of Gynecological and Obstetric Diseases) Downloadkeyboard_arrow_down Browse Figures Versions Notes Abstract Background: Intrahepatic cholestasis of pregnancy (ICP) is the most common reversible liver disorder linked to pregnancy, characterised by pruritus and elevated serum bile acids (BAs). Condition severity correlates with increased maternal and neonatal complications, and recent evidence highlights a significantly elevated risk of adverse perinatal outcomes, including stillbirth, when BA > 100 µmol/L. Methods: This retrospective study, conducted at a tertiary perinatology centre between 2019 and 2023, was performed in two phases. In the first phase, baseline group characteristics and pregnancy outcomes were compared between ICP and non-ICP (control) groups. In the second phase, outcomes were analysed across three ICP severity subgroups: mild (BA < 40 µmol/L), moderate (BA 40–99 µmol/L), and severe (BA ≥ 100 µmol/L). Results: A total of 210 patients diagnosed with ICP and 24,177 controls were included in the analysis. After multivariable regression, the results indicated that patients with severe ICP (BA ≥ 100 µmol/L) experienced significantly worse perinatal outcomes compared to those with mild or moderate disease: spontaneous preterm birth occurred in 26.7% of cases (p = 0.002), iatrogenic preterm birth in 36.7% (p < 0.001), meconium-stained amniotic fluid in 43.3% (p = 0.001), and neonatal intensive care unit (NICU) admission in 23.3% (p = 0.006). This subgroup also had the lowest mean birth weight (2830 g, p < 0.001). Notably, no stillbirths were recorded in any of the subgroups. Compared to controls, no major differences in maternal characteristics were noted, except in pregnancies conceived via in vitro fertilisation (IVF, p = 0.012) and those complicated by gestational diabetes (p = 0.040), both showing elevated risk for ICP development. Conclusions: This study confirms an association between ICP and increased perinatal complications, with severity of disease correlating with poorer outcomes. The findings highlight the need for standardised BA testing and improved strategies for perinatal management. |
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| Keywords: | intrahepatic cholestasis of pregnancy, peak bile acid, adverse perinatal outcomes, stillbirth |
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| Publication status: | Published |
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| Publication version: | Version of Record |
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| Year of publishing: | 2025 |
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| Number of pages: | str. 1-14 |
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| Numbering: | Vol. 15, issue 17, [article no.] 2185 |
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| PID: | 20.500.12556/DiRROS-24395  |
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| UDC: | 618.3 |
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| ISSN on article: | 2075-4418 |
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| DOI: | 10.3390/diagnostics15172185 |
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| COBISS.SI-ID: | 247037699 |
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| Note: | Nasl. z nasl. zaslona;
Opis vira z dne 29. 8. 2025;
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| Publication date in DiRROS: | 26.11.2025 |
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| Views: | 128 |
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| Downloads: | 43 |
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