Influence of total bile acid in maternal serum and cord blood on neonatal cardiac function from intrahepatic cholestasis of pregnancy

Abstract

To study the influence of total bile acid (TBA) of maternal serum and cord blood on neonatal cardiac function in women with intrahepatic cholestasis of pregnancy (ICP). The concentration of TBA in the maternal peripheral blood and neonatal cord blood were measured by enzyme in 30 women with ICP as patients group matched with 30 normogravidas as control group. The concentration of cardiac troponin I (cTnI) in cord blood was detected by monoclonal enzyme-linked immunosorbent assay. Fetal left ventricle Tei index was evaluated by color Doppler ultrasonoscope. (1) TBA concentration of maternal serum and cord blood at ICP group were significantly higher than that of control group [(36.0+/-9.6) micromol/L vs. (3.8+/-0.9) micromol/L, (10.1+/-2.0) micromol/L vs. (5.5+/-0.4) micromol/L, P<0.01]. TBA concentration of maternal serum at ICP group was significantly higher than that of neonatal cord blood (P<0.01). Meanwhile, TBA concentration of maternal serum at control group was significantly lower than that of neonatal cord blood (P<0.01). (2) The Tei index of neonatal left ventricle at ICP group were significantly higher than that of control (0.58+/-0.04 vs. 0.43+/-0.03, P<0.01). (3) The concentration of cTnI from cord blood (0.92+/-0.23) microg/L at ICP group were obviously higher than that of control group [(0.52+/-0.10) microg/L, P<0.01]. (4) The TBA concentration of cord blood at ICP group showed positive correlation with maternal blood TBA, cord blood cTnI and fetal left ventricle Tei index respectively (r=0.769, 0.635, 0.758, P<0.01). In the mean time, the positive correlation between the concentration of cTnI from cord blood and fetal left ventricle Tei index was also observed (r=0.637, P<0.01). Left ventricular dysfunction and myocardial injury were shown in the neonates with ICP, which might be associated with with the elevated TBA level of maternal blood. The Tei index of fetal left ventricle could be used as a reliable parameter to monitor cardiac function and the degree of injured myocardial muscles.