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Research paper
Published online: 2021-10-14
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Intrahepatic cholestasis of pregnancy — prevalence and ethnic distribution in northern Israel

Maya Frank Wolf1, Inshirah Sgayer1, Liat Yaron2, Oleg Shnaider1, Marwan Odeh1, Jacob Bornstein1, Michal Carmiel2
DOI: 10.5603/GP.a2021.0172
Affiliations
  1. Department of Obstetrics and Gynecology, Galilee Medical Center, Nahariya, and Azrieli Faculty of Medicine, Bar Ilan University, Israel
  2. Liver disease Unit, Galilee Medical Center, Nahariya, and Azrieli Faculty of Medicine, Bar Ilan University, Israel

open access

Ahead of Print
ORIGINAL PAPERS Obstetrics
Published online: 2021-10-14

Abstract

Objectives: Intrahepatic cholestasis of pregnancy (ICP) is charachterized by pruritis and elevated serum bile acids (BA) and is associated with adverse obstetrical outcomes. ICP etiology is poorly understood and its incidence varies with ethnicity and geographical distribution.

Objectives: Explore the prevalence and characteristics of ICP in the different Northern Israeli ethnic groups and compare maternal and perinatal outcomes according to disease severity.

Material and methods: Single-center retrospective study. Women who were diagnosed with ICP based on clinical presentation and elevated fasting BA (≥ 10 μmol/L) were included. Disease incidence, maternal and neonatal complications were explored according to ethnic subgroups analysis and obstetrical complications were examined according to disease severity.

Results: The incidence of ICP in the study population was 0.58%. Higher ICP incidence was found in our cohort compared with other reports arising from Central Israel (p < 0.001). The Christian patients had a higher incidence of ICP (1.1%) and preeclampsia (23.1%). A higher rate of neonatal intensive care unit (NICU) admissions was found in the Arab Muslim and Christian groups compared with the Jewish and Druze groups (p = 0.007).

A higher rate of preeclampsia was found in the severe (BA ≥ 40 μmol/L) ICP group (p < 0.001). Patients in the severe ICP group had earlier gestational age at delivery (37 versus 38.14 weeks, p < 0.001). Birth weight was significantly lower in the severe ICP group (p = 0.018).

Conclusions: The incidence of ICP at our institution was 0.58%, which is higher compared with previous reported Israeli incidence. Higher ICP and preeclampsia incidence were found among Arab Christian patients.

Abstract

Objectives: Intrahepatic cholestasis of pregnancy (ICP) is charachterized by pruritis and elevated serum bile acids (BA) and is associated with adverse obstetrical outcomes. ICP etiology is poorly understood and its incidence varies with ethnicity and geographical distribution.

Objectives: Explore the prevalence and characteristics of ICP in the different Northern Israeli ethnic groups and compare maternal and perinatal outcomes according to disease severity.

Material and methods: Single-center retrospective study. Women who were diagnosed with ICP based on clinical presentation and elevated fasting BA (≥ 10 μmol/L) were included. Disease incidence, maternal and neonatal complications were explored according to ethnic subgroups analysis and obstetrical complications were examined according to disease severity.

Results: The incidence of ICP in the study population was 0.58%. Higher ICP incidence was found in our cohort compared with other reports arising from Central Israel (p < 0.001). The Christian patients had a higher incidence of ICP (1.1%) and preeclampsia (23.1%). A higher rate of neonatal intensive care unit (NICU) admissions was found in the Arab Muslim and Christian groups compared with the Jewish and Druze groups (p = 0.007).

A higher rate of preeclampsia was found in the severe (BA ≥ 40 μmol/L) ICP group (p < 0.001). Patients in the severe ICP group had earlier gestational age at delivery (37 versus 38.14 weeks, p < 0.001). Birth weight was significantly lower in the severe ICP group (p = 0.018).

Conclusions: The incidence of ICP at our institution was 0.58%, which is higher compared with previous reported Israeli incidence. Higher ICP and preeclampsia incidence were found among Arab Christian patients.

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Keywords

intrapartum cholestasis of pregnancy; ethnicity; retrospective cohort review; maternal outcome; perinatal outcome

About this article
Title

Intrahepatic cholestasis of pregnancy — prevalence and ethnic distribution in northern Israel

Journal

Ginekologia Polska

Issue

Ahead of Print

Article type

Research paper

Published online

2021-10-14

DOI

10.5603/GP.a2021.0172

Keywords

intrapartum cholestasis of pregnancy
ethnicity
retrospective cohort review
maternal outcome
perinatal outcome

Authors

Maya Frank Wolf
Inshirah Sgayer
Liat Yaron
Oleg Shnaider
Marwan Odeh
Jacob Bornstein
Michal Carmiel

References (17)
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