Perinatal outcome of patients with early-onset intrahepatic cholestasis of pregnancy

Abstract

Objective To analyze the perinatal outcomes of patients with early-onset intrahepatic cholestasis of pregnancy (ICP). Methods A total of 100 pregnant women with ICP who were treated in Xiangxiang People’s Hospital from October 2015 to October 2017 were divided into early-onset group (39 cases, onset time<28 weeks of pregnancy) and late-onset group (61 cases, onset time≥28 weeks of pregnancy) according to onset weeks of ICP; and then, enrolled patients were divided into mild ICP group (78 cases) and severe ICP group (22 cases) according to levels of cholyglycine (CG) and total bile acid (TBA). Another 100 healthy preagnant women who underwent examination during the same period were selected as control group. Regression analysis were performed on all groups. Results In iochemical indexes, the levels of glucose challenge test (GCT), alanine aminotransferase (ALT), total bilirubin (TBiL), aspartate aminotrasferase (AST), TBA in mild ICP and severe ICP group were higher than those in control group (P<0.05); and the levels of GCT, ALT, TBiL, AST and TBA in mild ICP group were significantly lower than those in severe ICP group (P<0.05). In the aspect of onset time, the severity rate of early-onset group was significantly higher than that of late-onset group (P<0.05). In labor indexes, the Apgar score, newborn body weight and postpartum bleeding volume and gestational weeks of delivery of mild ICP group were superior to those of severe ICP group (P<0.05). Compared with those indicators in control group, gestational week in mild ICP group and severe ICP group was shorter, postpartum bleeding volume was more, and newborn body weight was lower and Apgar score was lower (all P<0.05). In perinatal outcome, the perinatal outcome of control group was better than that of mild ICP and severe ICP group (P<0.05), while the perinatal outcome of mild ICP group was better than that of severe ICP group (P<0.05). Conclusions The earlier onset of ICP disease, the worse the prognosis become in the patients with ICP. It is necessary to strengthen the detection of biochemical indexes and understand the development of the disease so as to give corresponding intervention and improve the outcome of pregnancy. Key words: Early-onset intrahepatic cholestasis of pregnancy; Perinatal outcome; Analysis