Abstract
BackgroundThe aim of this study was to determine whether intrahepatic cholestasis of pregnancy (ICP) is associated with causes of death during on average 35 years follow-up after the delivery.MethodsThe study population comprised 571 women with ICP in at least one pregnancy seen at Tampere University Hospital, Finland, between 1969 and 1988. ICP was verified from patient records. The previous and following subjects in the maternity ward diary were taken as controls for each ICP case. In total, there were 1333 controls. All underlying causes of death were obtained from Statistics Finland in March 2017. The deaths occurred during 1971–2015 and the causes of death were classified according to ICD-10.ResultsAltogether, 39 of the mothers with ICP (6.8%) and 111 of the controls (8.3%) had died by the end of 2015 (p = 0.267). There were more underlying causes of death from gastrointestinal diseases (15%) in the ICP group than in the control group (4%) (p = 0.011). The number of underlying causes of death due to diseases of the circulatory system were lower in the ICP group (13%) than in the control group (26%), although the finding was not statistically significant (p = 0.088). Moreover, neoplasms were the underlying cause of death in 46% of cases among mothers with ICP and in 41% of cases among the controls (p = 0.609). Diseases of the other organ systems were rare in both groups.ConclusionWomen with a history of ICP do not have an increased overall mortality. However, deaths from gastrointestinal diseases are overrepresented among women with a history of ICP.
Highlights
The aim of this study was to determine whether intrahepatic cholestasis of pregnancy (ICP) is associated with causes of death during on average 35 years follow-up after the delivery
Thereafter, we checked the written diagnosis behind the code, and if it referred to ICP, we included the case for further selection
There were no hepatobiliary neoplasms in the ICP group and only one in the control group
Summary
The aim of this study was to determine whether intrahepatic cholestasis of pregnancy (ICP) is associated with causes of death during on average 35 years follow-up after the delivery. Intrahepatic cholestasis of pregnancy (ICP) is a reversible liver dysfunction during pregnancy. It is characterized by otherwise unexplained pruritus, especially on the palms of the hands, soles of the feet, and the abdomen. ICP is associated with perinatal complications, for example meconium staining of the amniotic fluid, stillbirth and preterm delivery [2, 3]. Ursodeoxycholic acid is the primary treatment used for ICP [4]. The mother’s ICP symptoms usually resolve within 48 h of delivery and biochemical abnormalities resolve within 2–8 weeks [5]
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