title: Risk factors for adverse fetal outcomes among women with early- versus late-onset intrahepatic cholestasis of pregnancy.
abstract: OBJECTIVE
  To determine risk factors for adverse fetal outcomes (AFOs) among women with intrahepatic cholestasis of pregnancy (ICP) on the basis of time of onset.
  
  
  METHODS
  In a retrospective analysis, data were obtained for all women with ICP admitted to two centers in Guangzhou, China, between February 1, 1993, and January 31, 2014. Patients were divided into group A (early-onset ICP) and group B (late-onset ICP), and were further divided on the basis of severity. The frequency of AFOs was assessed.
  
  
  RESULTS
  Among 371 eligible women, 57 (15.4%) were in group A and 314 (84.6%) in group B. AFOs affected 20 (35.1%) women in group A and 67 (21.3%) in group B (P=0.024), and 12 (54.5%) of 22 women in group A and 21 (29.6%) of 71 in group B with severe ICP (P=0.032). Independent risk factors for AFO in group A were increased levels of serum bile acid (P=0.016) and alkaline phosphatase (P=0.004). Independent risk factors in group B were increased levels of alkaline phosphatase (P<0.001) and gamma-glutamyl transpeptidase (P=0.001).
  
  
  CONCLUSIONS
  Early-onset ICP is associated with a higher frequency of AFO than is late-onset ICP, especially in severe disease. The risk factors differ between early-onset and late-onset ICP.
authors.affiliation: Department of Gynaecology and Obstetrics, NanFang Hospital, Southern Medical University, Guangzhou, China.
authors.forename: Jin
authors.initials: J
authors.lastname: Jin
authors.affiliation: Department of Gynaecology and Obstetrics, ZhuJiang Hospital, Southern Medical University, Guangzhou, China.
authors.forename: Shi-lei
authors.initials: SL
authors.lastname: Pan
authors.affiliation: Department of Gynaecology and Obstetrics, NanFang Hospital, Southern Medical University, Guangzhou, China.
authors.forename: Li-ping
authors.initials: LP
authors.lastname: Huang
authors.affiliation: Department of Gynaecology and Obstetrics, NanFang Hospital, Southern Medical University, Guangzhou, China.
authors.forename: Yan-hong
authors.initials: YH
authors.lastname: Yu
authors.affiliation: Department of Gynaecology and Obstetrics, NanFang Hospital, Southern Medical University, Guangzhou, China.
authors.forename: Mei
authors.initials: M
authors.lastname: Zhong
authors.affiliation: Department of Hepatobiliary Surgery, NanFang Hospital, Southern Medical University, Guangzhou, China. Electronic address: guoweizhang77@hotmail.com.
authors.forename: Guo-wei
authors.initials: GW
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000469:Alkaline Phosphatase / Q000097:blood; D001647:Bile Acids and Salts / Q000097:blood; D002681:China; D002780:Cholestasis, Intrahepatic / Q000150:complications* / Q000503:physiopathology; D005260:Female; D005315:Fetal Diseases / Q000453:epidemiology*; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000503:physiopathology; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D055815:Young Adult; D005723:gamma-Glutamyltransferase / Q000097:blood
chemical_list: D001647:Bile Acids and Salts; D005723:gamma-Glutamyltransferase; D000469:Alkaline Phosphatase
keywords: Adverse fetal outcomes; Intrahepatic cholestasis of pregnancy; Risk factor