Good pregnancy outcome despite intrahepatic cholestasis

• Published in: Scandinavian journal of primary health care 2010-01, Vol.28 (2), p.102-107
• Main Authors: Turunen, Kaisa, Sumanen, Markku, Haukilahti, Riitta-Liisa, Kirkinen, Pertti, Mattila, Kari
• Format: Article
• Language: English
• Subjects: Adult; Caesarean section; Cesarean Section; Cholestasis; Cholestasis, Intrahepatic - complications; Cholestasis, Intrahepatic - diagnosis; Cholestasis, Intrahepatic - therapy; Clinical outcomes; Delivery, Obstetric; Family Practice; Female; Finland; Humans; Infant, Newborn; intrahepatic cholestasis; Length of Stay; Maternal Age; Maternal Health Services; Original; Pregnancy; Pregnancy Complications - diagnosis; Pregnancy Complications - therapy; Pregnancy Outcome; Pregnant women; primary healthcare; Retrospective Studies; Risk Factors
• ISSN: 0281-3432; 1502-7724
• DOI: 10.3109/02813431003784001

Abstract Objective. Pregnant women complaining of itching are screened for intrahepatic cholestasis (ICP) by laboratory tests in primary healthcare. Cases of ICP are referred to specialist care. In Finland, ICP occurs in 1% of pregnancies. The aim was to study the outcome of deliveries. Design. Retrospective study of ICP pregnancies. Data were collected from the hospital discharge register, patient records, and the labour register. Setting. The region of Tampere University Hospital in Finland. Subjects. Altogether 687 ICP cases from 1969 to 1988 and two controls for each. Main outcome measures. ICP patients were compared with controls in terms of mother's age, pregnancy multiplicity, weeks of gestation at delivery, frequency of induction and Caesarean section, length of ward period, child's weight, Apgar scores, and stillbirth. Results. For ICP patients, the risk for hospital stay of 10 days or more was eightfold (OR 8.41), for gestational weeks less than 37 at delivery sevenfold (OR 7.02), for induction threefold (OR 3.26), for baby's low weight at birth almost twofold (OR 1.86), and for Caesarean section one and a half fold (OR 1.47). The possibility of the incidence of multiple pregnancy was two and a half fold (OR 2.49, 95%). ICP was not associated with mother's age, the baby's risk of stillbirth, or low Apgar scores. Conclusion. ICP mothers are found and taken care of appropriately, and thus ICP is only a minor risk for mothers and their children.