Bile-acid levels and lung maturity test in patients with intrahepatic cholestasis of pregnancy
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Itamar D. Futterman
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Howard Minkoff
Abstract
Objectives
Prolonged fetal exposure to maternal bile acids have been linked to fetal lung injury, but it is not known if it affects production of surfactant or fetal lung maturity tests. We set out to determine if elevated total bile acid (TBA) levels predict delayed fetal lung maturity (FLM) in patients with intrahepatic cholestasis of pregnancy (ICP).
Methods
A retrospective cohort study examining patients with ICP who underwent amniocentesis between 36+0 and 37+6 between 2005 and 2014. Primary goal was to identify if a relationship exists between TBA levels and FLM defined as Lecithin:Sphingomyelin >2.5, detectable Phosphatidylglycerol, or lamellar body count of >50,000.
Results
Among the 113 patients, there was no statistically significant difference in TBA levels between women with FLM and those with immaturity (31.3 [21.6, 44.5] μmol/L and 34.9 [23.9, 62.3] μmol/L respectively; p=0.16). Logistic regression performed using predefined TBA levels of 20, 30, 40 and 50 μmol/L revealed that TBA levels did not predict a negative FLM test at time of amniocentesis.
Conclusions
TBA levels do no predict presence or absence of FLM between 36+0 and 37+6 weeks of gestation. Though certain pregnancy complications can affect FLM, we could not identify a correlation between TBA levels and an accelerated or delayed lung maturation process.
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Research funding: None declared.
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Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
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Competing interests: Authors state no conflict of interest.
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Informed consent: Informed consent was obtained from all individuals included in this study.
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Ethical approval: The local Institutional Review Board deemed the study exempt from review.
References
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© 2022 Walter de Gruyter GmbH, Berlin/Boston
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Artikel in diesem Heft
- Frontmatter
- Review
- Obstetric hemorrhage: effective methods for addressing the menace in Sub-Saharan Africa
- Mini Review
- The use of neurally-adjusted ventilatory assist (NAVA) for infants with congenital diaphragmatic hernia (CDH)
- Opinion Paper
- The role of specialist perinatal psychiatrists in modern medicine
- Corner of Academy
- Maternal perception of fetal movements: onset and associated factors
- Original Articles – Obstetrics
- Cervical ripening as an outpatient procedure in the pandemic – minimizing the inpatient days and lowering the socioeconomic costs
- Can sonographic imaging of the fetal pancreas predict perinatal outcomes in gestational diabetes mellitus?
- Comparison of transvaginal sonographic cervical length measurement and Bishop score for predicting labour induction outcomes
- Regional differences in utilization of 17α-hydroxyprogesterone caproate (17-OHP)
- Effect of anesthesia selection on neonatal outcomes in cesarean hysterectomies for placenta accreta spectrum (PAS)
- Bile-acid levels and lung maturity test in patients with intrahepatic cholestasis of pregnancy
- Evaluation of appropriate vancomycin prescribing for the prevention of newborn group B streptococcal infections in a community hospital obstetrics service
- Effect of supplementation with 5,000 IU of vitamin D on the glycemic profile of women with gestational diabetes mellitus
- Association of methylenetetrahydrofolate reductase (MTHFR) gene polymorphisms with vitamin B12 deficiency and adverse perinatal outcomes among pregnant women of rural South India – a cross sectional longitudinal study
- Original Article – Fetus
- Fetal autopsy for the diagnosis of skeletal dysplasia and comparison with prenatal ultrasound findings over a 16-year period
- Original Articles – Neonates
- Neonatal admission rate after vaginal breech delivery
- Extremely low gestational age neonates and resuscitation: survey on perspectives of Canadian neonatologists
- The effect of 150 and 80 mg doses of aspirin on preventing preterm birth in high-risk pregnant women
- Letters to the Editor
- Aspirin for the prevention of preeclampsia
- Reply to: Aspirin for the prevention of preeclampsia
- Total bile acid levels for clinically suspected intrahepatic cholestasis of pregnancy
- Reply: Neonatal lung injury with intrahepatic cholestasis of pregnancy
- Marijuana and pregnancy: just because its legal doesn’t make it safe
- Corrigenda
- Stillbirth aftercare in a tertiary obstetric center–parents’ experiences
- Prospective risk of stillbirth according to fetal size at term
