title: Predictors of premature delivery in patients with intrahepatic cholestasis of pregnancy.
abstract: OBJECTIVE
  To evaluate the predictive value of clinical symptoms and biochemical parameters for prematurity in intrahepatic cholestasis of pregnancy (ICP).
  
  
  METHODS
  Sixty symptomatic patients with ICP were included in this retrospective analysis. Preterm delivery was defined as delivery before 37 wk gestation. Predictors of preterm delivery were disclosed by binary multivariate logistic regression analysis.
  
  
  RESULTS
  Mean time of delivery was 38.1 +/- 1.7 wk. No stillbirths occurred. Premature delivery was observed in eight (13.3%) patients. Total fasting serum bile acids were higher (47.8 +/- 15.2 vs 41.0 +/- 10.0 mumol/L, P < 0.05), and pruritus tended to start earlier (29.0 +/- 3.9 vs 31.6 +/- 3.3 wk, P = 0.057) in patients with premature delivery when compared to those with term delivery. Binary multivariate logistic regression analysis revealed that early onset of pruritus (OR 1.70, 95% CI 1.23-2.95, P = 0.038) and serum bile acid (OR 2.13, 95% CI 1.13-3.25, P = 0.013) were independent predictors of preterm delivery.
  
  
  CONCLUSIONS
  Early onset of pruritus and high levels of serum bile acids predict preterm delivery in ICP, and define a subgroup of patients at risk for poor neonatal outcome.
authors: Department of Gastroenterology, Kaunas University of Medicine, Eiveniu Street 2, Kaunas 50009, Lithuania. jukond@takas.lt
authors: Jurate
authors: J
authors: Kondrackiene
authors: Ulrich
authors: U
authors: Beuers
authors: Rimantas
authors: R
authors: Zalinkevicius
authors: Horst-Dietmar
authors: HD
authors: Tauschel
authors: Vladas
authors: V
authors: Gintautas
authors: Limas
authors: L
authors: Kupcinskas
mesh_terms: D000293:Adolescent; D000328:Adult; D001647:Bile Acids and Salts / Q000097:blood; D002780:Cholestasis, Intrahepatic / Q000097:blood / Q000503:physiopathology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D007752:Obstetric Labor, Premature / Q000097:blood / Q000209:etiology* / Q000503:physiopathology; D011237:Predictive Value of Tests; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood / Q000503:physiopathology*; D011256:Pregnancy Outcome; D011537:Pruritus / Q000175:diagnosis / Q000503:physiopathology; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D001647:Bile Acids and Salts