title: Pruritus in pregnancy: a study of anatomical distribution and prevalence in relation to the development of obstetric cholestasis.
abstract: The main objective of this study was to determine the prevalence and anatomical distribution of pruritus in 6532 pregnant women from a UK antenatal population. Pregnant women attending and completing antenatal care at two general hospitals over a 12-month period were recruited and contacted on three occasions by post. Medical advice and a questionnaire detailing the nature and severity of their pruritus were included. Pruritus in pregnancy, as reported by questionnaire, affected approximately 23% of pregnancies (n = 1521/6532 women) and 1.6% (n = 25) of these women developed obstetric cholestasis (OC). Overall, 0.66% of the antenatal population (43/6532) had a clinical diagnosis of OC (95% CI: 0.48-0.89%). Itching unrelated to OC was most commonly reported to be worst on the abdomen (31%, 616/2014). Women with OC reported pruritus to be most severe on the palms and soles in 16% (4/25) and 'all over' in 24% (6/25) compared with 5% (54/1120) (P < 0.05) and 4% (42/1120, P < 0.0001) of those without OC. In conclusion, pruritus affected approximately one in four women and OC one in 135 women during the study period. Women whose pruritus is 'all over' or most severe on the 'palms or soles' may be at greater risk of the disease.
authors: Maternal and Fetal Research Unit, Division of Reproduction and Endocrinology, King's College.
authors: A P
authors: AP
authors: Kenyon
authors: Maternal and Fetal Research Unit, Division of Reproduction and Endocrinology, King's College.
authors: R M
authors: RM
authors: Tribe
authors: Maternal and Fetal Research Unit, Division of Reproduction and Endocrinology, King's College.
authors: C
authors: C
authors: Nelson-Piercy
authors: West Middlesex University Hospital.
authors: J C
authors: JC
authors: Girling
authors: Imperial College , London.
authors: C
authors: C
authors: Williamson
authors: Maternal and Fetal Research Unit, Division of Reproduction and Endocrinology, King's College.
authors: P T
authors: PT
authors: Seed
authors: Department of Dermatology, St Peter's Hospital Chertsey , Surrey , UK.
authors: S
authors: S
authors: Vaughan-Jones
authors: Maternal and Fetal Research Unit, Division of Reproduction and Endocrinology, King's College.
authors: A H
authors: AH
authors: Shennan
keywords: intrahepatic cholestasis of pregnancy; obstetric cholestasis; polymorphic eruption of pregnancy; prurigo; pruritus; pruritus gravidarum