title: Can routine laboratory parameters predict adverse pregnancy outcomes in intrahepatic cholestasis of pregnancy?
abstract: OBJECTIVE
  Our aim was to investigate whether any hematological changes readily detectable by simple complete blood count (CBC), as well as fasting and postprandial total serum bile acid (SBA) levels, have diagnostic values for the prediction of adverse pregnancy outcomes in intrahepatic cholestasis of pregnancy (ICP).
  
  
  METHODS
  A prospective, case control study was carried out including 217 pregnant women (117 women with ICP and 100 healthy controls). The main outcome measures investigated were preterm delivery, APGAR scores, and neonatal unit admission. A multivariate logistic regression model was used to identify the independent risk factors of adverse pregnancy outcomes.
  
  
  RESULTS
  Compared with controls, women with ICP had significantly higher mean platelet volume (MPV) (mean 10.2±1.0 vs. 11.0±1.3; P<0.001) and platelet distribution width (PDW) (mean 13.1±2.3 vs. 14.7±2.8; P<0.001) values. Analysis with logistic regression revealed that the probability of preterm delivery did not increase until MPV levels exceeded 11.2 fL [odds ratio (OR)=2.68, 95% confidence interval (CI)=1.13-6.32, P=0.025], and total bilirubin levels exceeded 0.6 mg/dL (OR=3.13, 95% CI=1.21-8.09, P=0.019). Considering the low APGAR scores, only increased postprandial total SBA levels of ≥51 μmol/L were found to be predictive significantly (OR=3.02, 95% CI=1.07-8.53, P=0.037).
  
  
  CONCLUSIONS
  Our study suggests that increased MPV and total bilirubin levels are associated with preterm delivery, and increased postprandial total SBA levels are predictive for low APGAR in ICP patients.
authors.forename: Efser
authors.initials: E
authors.lastname: Oztas
authors.forename: Kudret
authors.initials: K
authors.lastname: Erkenekli
authors.forename: Sibel
authors.initials: S
authors.lastname: Ozler
authors.forename: Ali Ozgur
authors.initials: AO
authors.lastname: Ersoy
authors.forename: Mevlut
authors.initials: M
authors.lastname: Kurt
authors.forename: Erkin
authors.initials: E
authors.lastname: Oztas
authors.forename: Dilek
authors.initials: D
authors.lastname: Uygur
authors.forename: Nuri
authors.initials: N
authors.lastname: Danisman
mesh_terms: D000293:Adolescent; D000328:Adult; D001034:Apgar Score; D001647:Bile Acids and Salts / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D001772:Blood Cell Count; D016022:Case-Control Studies; D002780:Cholestasis, Intrahepatic / Q000097:blood / Q000175:diagnosis*; D005260:Female; D006801:Humans; D016015:Logistic Models; D063847:Mean Platelet Volume; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood / Q000175:diagnosis*; D011256:Pregnancy Outcome; D047928:Premature Birth / Q000209:etiology; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D055815:Young Adult
chemical_list: D001647:Bile Acids and Salts; D015415:Biomarkers