Intrahepatic cholestasis of pregnancy is correlated with adverse perinatal outcomes, however, its relationship with the concentration of specific biochemical markers is indistinct. The authors of the present study aimed to determine the adverse perinatal effects of intrahepatic cholestasis of pregnancy in women with increased serum bile acid concentrations. Additionally, whether elevated bile acid concentrations were associated with the risk of stillbirth and preterm birth were also investigated.

The study included trial from PubMed, Web of Science, and Embase databases from database inception to June 1, 2018, describing perinatal outcomes for women with intrahepatic cholestasis of pregnancy. Logistic and stepwise logistic regression was used to analyze the associations between biochemical markers and adverse outcomes.

Based on these observations, it can be inferred that women with intrahepatic cholestasis of pregnancy and singleton pregnancies are associated with increased risk of stillbirth, when serum bile acids concentrations are of 100 μmol/L or more. Therefore, based on the fact that most women with intrahepatic cholestasis of pregnancy have bile acids below this concentration, these women can be comforted that their risk of stillbirth is comparable to that of pregnant women in the general population. 

Source: The Lancet. 10174(393);2019: P899-909.