The prevalence of intrahepatic cholestasis of pregnancy in a primarily Latina Los Angeles population.
OBJECTIVE
To establish the prevalence of intrahepatic cholestasis of pregnancy (ICP) in a primarily Latina population in the United States.


METHODS
Over a period of 16 months, a convenience sample of subjects admitted to labor and delivery in the third trimester was enrolled. Each subject completed a questionnaire rating their severity of pruritus on a numeric scale of 1 to 10. Serum was analyzed via radioimmunoassay for total bile acid concentration. ICP was defined as pruritus score >4 and a total serum bile acid concentration of >or=20 micromol/l. Ethnicity was determined from hospital record demographic data.


RESULTS
All invited participants enrolled in the study. Three hundred and forty subjects were enrolled. Three hundred and sixteen subjects (93%) were identified as Latina. The serum bile acid concentration range for the entire study population was 1 to 580 micromol/l with a mean of 10.4+/-34.9 micromol/l. Twenty-four (7.1%) subjects had a serum bile acid concentration >or=20 micromol/l. A pruritus score >4 was found in 19.7% (67/340). Of the 24 subjects with a bile acid concentration >or=20 micromol/l, 19 also had a pruritus score >4. Thus, the prevalence of ICP in this population was 5.6% (19/340). In subjects with ICP, the mean serum bile acid concentration was 89.5+/-124.0 micromol/l. When controlling for confounders, women with ICP were associated with higher rates of chorioamnionitis (P=0.043) and their fetuses had higher rates of thick meconium (P=0.053).


CONCLUSIONS
The overall prevalence of ICP in this population was 5.6%, 10 to 100 times higher than previously reported data from the United States. Larger studies of perinatal morbidity examining the diagnostic criteria of cholestasis need to be conducted.
Lee
R H
RH
Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Los Angeles County-University of Southern California Medical Center, Women's and Children's Hospital, 90033, USA. richarhl@usc.edu
Goodwin
T M
TM
Greenspoon
J
J
Incerpi
M
M
D000328:Adult; D001647:Bile Acids and Salts / Q000097:blood; D002780:Cholestasis, Intrahepatic / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology* / Q000208:ethnology; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D015141:Los Angeles / Q000453:epidemiology; D011237:Predictive Value of Tests; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology* / Q000208:ethnology; D011256:Pregnancy Outcome; D015995:Prevalence; D011446:Prospective Studies; D011537:Pruritus / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
D001647:Bile Acids and Salts