Early and later intrahepatic cholestasis of pregnancy (ICP): Study of adverse pregnancy outcomes

Objective. - To compare the risk for adverse pregnancy and fetal outcomes in early or late-onset intrahepatic cholestasis of pregnancy (ICP). Methods. - In a retrospective and unicentric analysis, data were collected for all women with ICP (serum bile acid level over 8 mol/L) between June 1, 2008 and January 1, 2015. Patients were divided in earlyonset ICP (pregnancy duration at diagnosis < 33 weeks) and late-onset ICP (pregnancy duration at diagnosis > 33 weeks). The frequency of adverse pregnancy and fetal outcomes was assessed. Results. - Among 138 eligible women, 40 were in the early-onset group and 98 in the late-onset group. Adverse pregnancy or fetal outcomes affected significantly more patients in early-onset ICP group (45% versus 17.3%, P < 0.05). Threatened preterm birth (30% versus 10.0%, P < 0.05) was significantly increased in early-onset ICP group. Prematurity was higher in early-onset group (40.0% versus 28.0%, P = 0.23). Early-onset and severe ICP were not significantly linked (P = 0.16). Conclusion. - Early-onset ICP diagnosed before 33 Weeks is associated with adverse pregnancy outcomes, particularly threatened preterm birth. (C) 2018 Published by Elsevier Masson SAS.