Determinants of pregnancy outcomes in early-onset intrahepatic cholestasis of pregnancy.

OBJECTIVES

To analyze pregnancy outcomes and factors influencing early-onset intrahepatic cholestasis of pregnancy (ICP), offering insights to improve the management, diagnosis, and treatment of ICP during pregnancy.

METHODS

We categorized 127 pregnant women with ICP into two groups based on a gestational age cutoff of 28 weeks. The analysis centered on biochemical markers, pregnancy complications, and outcomes to identify factors influencing early-onset ICP.

RESULTS

We found that biochemical markers including alanine aminotransferase, aspartate aminotransferase, gamma-glutamyl transferase (GGT), alkaline phosphatase, total bilirubin, direct bilirubin (DBIL), indirect bilirubin, and cholesterol were significantly lower in early-onset ICP compared to late-onset ICP. Importantly, premature birth rates were higher in the early-onset ICP group. Through univariate and multivariate logistic regression analyses of these biochemical markers, GGT and DBIL emerged as significant predictive factors (OR=0.84 and 0.54).

CONCLUSIONS

Early-onset ICP is characterized by its early onset, prolonged duration, and a higher incidence of premature births compared to late-onset ICP, leading to adverse perinatal outcomes. This research underscores the protective role of GGT and DBIL in early-onset ICP.