The influence of the serum liver function, α-glutathione S-transferase and α-hydroxybutyrate dehydrogenase on pregnancy outcome in patients with intrahepatic cholestasis of pregnancy

Abstract

Objective To explore the influence of the serum liver function, α-glutathione S-transferase(α-GST) and α-hydroxybutyrate dehydrogenase(α-HBDH) on pregnancy outcome in patients with intrahepatic cholestasis of pregnancy(ICP). Methods Retrospective analysis was conducted on the clinical data of 80 cases with ICP who admitted in our hospital from January 2013 to December 2015.The patients were divided into mild group and severe group.Biochemical indicators and the indicators reflecting poor pregnancy outcomes were analyzed. Results The levels of alanine transferase(ALT), aspartate transferase(AST), total bile acid(TBA) and direct bilirubin(DB) in the severe group were significantly higher than those in the mild group(t=4.07, 3.45, 3.50, 2.11, P=0.04, P<0.01). The incidence rate of fetal distress, premature delivery and pollution of amniotic fluid above II degree was significantly higher in the severe group(χ2=8.352, all P<0.01). There were no significant differences in gestational weeks, cesarean section rate, the amount of postpartum hemorrhage and neonatal birth weight between the two groups (χ2=4.178, P=0.892). Logistic regression analysis showed that gestational weeks, neonatal birth weight and the levels of TBA, AST, ALT, α-GST and α-HBDH were associated with the severity of ICP(all P<0.01). α-GST had higher sensitivity and specificity in predicting adverse perinatal outcomes, such as amniotic fluid, premature rupture of membranes, preterm birth, low birth weight and fetal distress. Conclusion The perinatal outcomes of pregnant women with severe ICP can be improved by grading management according to their serum biochemical indicators and active clinical intervention treatment.α-GST and α-HBDH can be used to evaluate the severity of ICP, which have higher clinical value in predicting poor pregnancy outcomes. Key words: Cholestasis, intrahepatic; Pregnancy; Glutathione s-transferase; Hydroxybutyrate dehydrogenase; Pregnancy outcomes