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Pregnancy Outcome With Intrahepatic Cholestasis

From the Department of Obstetrics and Gynecology, Kuopio University Hospital, Kuopio, Finland.

Address reprint requests to: Seppo Heinonen, MD, PhD Department of Obstetrics and Gynecology Kuopio University Hospital 70211 Kuopio Finland E-mail: seppo.heinonen{at}kuh.fi

Objective: To determine the risk of adverse pregnancy outcomes resulting from intrahepatic cholestasis.

Methods: We analyzed 91 women with singleton pregnancies complicated by cholestasis who gave birth at Kuopio University Hospital from January 1990 to December 1996. Logistic regression analysis was used to compare pregnancy outcomes of this group with those of the general obstetric population (n = 16,818).

Results: Women of relatively advanced age (over 35 years) were at increased risk of developing intrahepatic cholestasis. Affected pregnant women delivered by cesarean significantly more often (25.3%) than the general obstetric population (15.8%). Intrahepatic cholestasis increased the low basic risk of preterm delivery and the need for neonatal care in the general population (odds ratio [OR] 2.73; 95% confidence interval [CI] 1.50, 4.95 and OR 2.15; 95% CI 1.21, 3.83, respectively). Otherwise, the courses of pregnancy were comparable in both groups.

Conclusion: Intrahepatic cholestasis has an adverse effect on fetal development, and affected pregnancies merit closer surveillance. Delivery of infants when maturity is reached may minimize the risk of adverse outcomes.

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