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Licensed Unlicensed Requires Authentication Published by De Gruyter October 8, 2014

Can routine laboratory parameters predict adverse pregnancy outcomes in intrahepatic cholestasis of pregnancy?

  • Efser Oztas EMAIL logo , Kudret Erkenekli , Sibel Ozler , Ali Ozgur Ersoy , Mevlut Kurt , Erkin Oztas , Dilek Uygur and Nuri Danisman

Abstract

Aim: 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.


Corresponding author: Efser Oztas, Department of Obstetrics and Gynecology, Zekai Tahir Burak Women’s Health Education and Research Hospital, Ankara, Turkey, Tel.: +90 0 31 23 06 50 00, Fax: +90 0 31 23 12 49 31, E-mail:

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The authors stated that there are no conflicts of interest regarding the publication of this article.

Received: 2014-6-17
Accepted: 2014-9-15
Published Online: 2014-10-8
Published in Print: 2015-11-1

©2015 by De Gruyter

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