title: Predicting fetal asphyxia in intrahepatic cholestasis of pregnancy.
abstract: OBJECTIVE
  Intrahepatic cholestasis of pregnancy (ICP) is a disease associated with high-perinatal morbidity and mortality rates. It is important to have parameters that aid in predicting fetal outcomes. Certain parameters affecting asphyxia in newborns to mothers with ICP are evaluated in this study.
  
  
  METHODS
  One hundred eighty-seven cholestatic pregnancies were analyzed, retrospectively. Fetal asphyxia was defined as an APGAR score of less than 7 at 5 min postpartum. Predictors of asphyxia in ICP were analyzed by binary multivariate logistic regression analysis.
  
  
  RESULTS
  Thirty-six of the cholestatic pregnancies ended up having an asphyctic newborn at the time of delivery (19.2%). There was a statistically significance difference in the levels of total bile acids (TBA) (42.4 +/- 15.2 vs. 33.8 +/- 12.9 micromol/L, P < 0.01), HDL cholesterol (54.2 +/- 15.9 vs. 61.3 +/- 12.2, P = 0.01), total cholesterol (279.0 +/- 51.4 vs. 257.7 +/- 51.6, P = 0.02), and triacylglycerol (299.4 +/- 94.6 vs. 260.4 +/- 118.7) between the asphytic and nonasphytic group. Binary multivariate logistic regression analysis demonstrated that TBA levels (OR 1.04, 95% CI 1.01-1.08, P = 0.03) and exposure time (OR 1.11, 95% CI 1.05-1.17, P < 0.01) were the most important independent variables predicting fetal asphyxia in ICP.
  
  
  CONCLUSIONS
  In this study, it has been demonstrated that for the evaluation of fetal status, increased TBA levels in the mother and increased exposure time for the fetus to these increased values of TBA within the maternal circulation system help to predict increased risk of asphyxia in newborns to ICP mothers.
authors.affiliation: Department of Obstetrics and Gynecology, Agean Obstetrics and Gynecology Training and Research Hospital, Izmir, Turkey. dcoztekin@gmail.com
authors.forename: Deniz
authors.initials: D
authors.lastname: Oztekin
authors.forename: Ipek
authors.initials: I
authors.lastname: Aydal
authors.forename: Ozgur
authors.initials: O
authors.lastname: Oztekin
authors.forename: Sabriye
authors.initials: S
authors.lastname: Okcu
authors.forename: Rengin
authors.initials: R
authors.lastname: Borekci
authors.forename: Sivekar
authors.initials: S
authors.lastname: Tinar