Determinants of pregnancy outcomes in early-onset intrahepatic cholestasis of pregnancy.

Objectives: To analyze pregnancy outcomes and factors influencing early-onset intrahepatic cholestasis of pregnancy (ICP), offering insights to improve the management, diagnosis, and treatment of ICP during pregnancy.

Methods: We categorized 127 pregnant women with ICP into two groups based on a gestational age cutoff of 28 weeks. The analysis centered on biochemical markers, pregnancy complications, and outcomes to identify factors influencing early-onset ICP.

Results: We found that biochemical markers including alanine aminotransferase, aspartate aminotransferase, gamma-glutamyl transferase (GGT), alkaline phosphatase, total bilirubin, direct bilirubin (DBIL), indirect bilirubin, and cholesterol were significantly lower in early-onset ICP compared to late-onset ICP. Importantly, premature birth rates were higher in the early-onset ICP group. Through univariate and multivariate logistic regression analyses of these biochemical markers, GGT and DBIL emerged as significant predictive factors (OR=0.84 and 0.54).

Conclusions: Early-onset ICP is characterized by its early onset, prolonged duration, and a higher incidence of premature births compared to late-onset ICP, leading to adverse perinatal outcomes. This research underscores the protective role of GGT and DBIL in early-onset ICP.