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BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2024

Open Access 01-12-2024 | Pregnancy Cholestasis | Research

Maternal and neonatal outcomes of intrahepatic cholestasis of pregnancy after in vitro fertilization

Authors: Ying Zhu, Le Xu, Rajluxmee Beejadhursing, Fei Li

Published in: BMC Pregnancy and Childbirth | Issue 1/2024

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Abstract

Background

Intrahepatic cholestasis of pregnancy (ICP) is an idiopathic disease of pregnancy. Little is known about how it specifically affects pregnancies resulting from in vitro fertilization (IVF). Our aim is to evaluate the impact of IVF on the perinatal outcomes of ICP.

Methods

A retrospective study of 242 patients with intrahepatic cholestasis of pregnancy, comprising 36 conceived through IVF and 206 spontaneous conceptions (SC), enrolled between 2019 and 2021 was carried out. Data were analyzed from the medical archives of the Huazhong University of Science and Technology, Tongji Hospital.

Results

Numerical values of transaminases (ALT, alanine aminotransferase; AST, aspartate aminotransferase) and serum total bile acid (TBA) are significantly lower in the IVF group than that in the spontaneous conceived group (p < 0.05). The incidence of gestational diabetes mellitus (GDM) was higher in the IVF group than in SC group (30.6% vs. 16%, p = 0.037). The cesarean section (CS) rates are higher in the IVF group (97.2% vs. 85.4%, p = 0.023). On the other hand, the prevalence of premature rupture of membranes (PROM) was higher in the SC group (10.7%) while none was reported in the IVF-ICP group. Other maternal comorbidities and neonatal outcomes were similar between the two groups.

Conclusion

ICP patients who underwent IVF are more likely to suffer from GDM. Therefore, monitoring and management of blood glucose should be strengthened during pregnancy. Fortunately, IVF does not seem to worsen the progression or outlook of ICP, so sticking to standard management practices is recommended.
Literature
1.
Geenes V, Williamson C. Liver disease in pregnancy, Best Pract Res Clin Obstet Gynaecol, vol. 29, no. 5, pp. 612 – 24, Jul, 2015.
2.
Basaranoglu S, Agacayak E, Ucmak F, Tunc SY, Deregozu A, Akkurt ZM, et al. The role of vitamin B1-B2 and plasma lipid profile in intrahepatic cholestasis of pregnancy. J Perinat Med. 2017;45(4):461–5.CrossRefPubMed
3.
Batsry L, Zloto K, Kalter A, Baum M, Mazaki-Tovi S, Yinon Y. Perinatal outcomes of intrahepatic cholestasis of pregnancy in twin versus singleton pregnancies: is plurality associated with adverse outcomes? Arch Gynecol Obstet, vol. 300, no. 4, pp. 881–887, Oct, 2019.
4.
Furrer R, Winter K, Schaffer L, Zimmermann R, Burkhardt T, Haslinger C. Postpartum Blood Loss in Women Treated for Intrahepatic Cholestasis of Pregnancy, Obstet Gynecol, vol. 128, no. 5, pp. 1048–1052, Nov, 2016.
5.
Puljic A, Kim E, Page J, Esakoff T, Shaffer B, LaCoursiere DY et al. The risk of infant and fetal death by each additional week of expectant management in intrahepatic cholestasis of pregnancy by gestational age. Am J Obstet Gynecol, vol. 212, no. 5, pp. 667 e1-5, May, 2015.
6.
Abu-Hayyeh S, Papacleovoulou G, Lovgren-Sandblom A, Tahir M, Oduwole O, Jamaludin NA, Ravat S et al. Feb,. Intrahepatic cholestasis of pregnancy levels of sulfated progesterone metabolites inhibit farnesoid X receptor resulting in a cholestatic phenotype, Hepatology, vol. 57, no. 2, pp. 716 – 26, 2013.
7.
Tang M, Xiong L, Cai J, Fu J, Liu H, Ye Y et al. Intrahepatic cholestasis of pregnancy: insights into pathogenesis and advances in omics studies. Hepatol Int, Nov 13, 2023.
8.
Wood AM, Livingston EG, Hughes BL, Kuller JA. Intrahepatic Cholestasis of Pregnancy: A Review of Diagnosis and Management, Obstet Gynecol Surv, vol. 73, no. 2, pp. 103–109, Feb, 2018.
9.
Wang J, Liu Q, Deng B, Chen F, Liu X, Cheng J. Pregnancy outcomes of Chinese women undergoing IVF with embryonic cryopreservation as compared to natural conception. BMC Pregnancy Childbirth, vol. 21, no. 1, pp. 39, Jan 9, 2021.
10.
Zhu L, Zhang Y, Liu Y, Zhang R, Wu Y, Huang Y et al. Maternal and live-birth outcomes of pregnancies following assisted Reproductive Technology: a retrospective cohort study. Sci Rep, vol. 6, pp. 35141, Oct 20, 2016.
11.
Yu HF, Chen HS, Rao DP, Gong J. Association between polycystic ovary syndrome and the risk of pregnancy complications: a PRISMA-compliant systematic review and meta-analysis. Med (Baltim), vol. 95, no. 51, pp. e4863, Dec, 2016.
12.
Vannuccini S, Clifton VL, Fraser IS, Taylor HS, Critchley H, Giudice LC et al. Infertility and reproductive disorders: impact of hormonal and inflammatory mechanisms on pregnancy outcome, Hum Reprod Update, vol. 22, no. 1, pp. 104 – 15, Jan-Feb, 2016.
13.
Piechota J, Jelski W. Intrahepatic Cholestasis in pregnancy: review of the literature. J Clin Med, vol. 9, no. 5, May 6, 2020.
14.
ElSayed NA, Aleppo G, Aroda VR, Bannuru RR, Brown FM, Bruemmer D, et al. On behalf of the American Diabetes, 2. Classification and diagnosis of diabetes: standards of Care in Diabetes-2023. Diabetes Care. 2023;46(Suppl 1):S19–S.CrossRef
15.
Glantz A, Marschall HU, Mattsson LA. Intrahepatic cholestasis of pregnancy: Relationships between bile acid levels and fetal complication rates, Hepatology, vol. 40, no. 2, pp. 467 – 74, Aug, 2004.
16.
Rezai S, Lam J, Henderson CE. Intrahepatic cholestasis of pregnancy: maternal and fetal outcomes associated with elevated bile acid levels, Am J Obstet Gynecol, vol. 213, no. 1, pp. 114, Jul, 2015.
17.
Lei LL, Lan YL, Wang SY, Feng W, Zhai ZJ. Perinatal complications and live-birth outcomes following assisted reproductive technology: a retrospective cohort study. Chin Med J (Engl), vol. 132, no. 20, pp. 2408–16, Oct 20, 2019.
18.
Abu-Hayyeh S, Ovadia C, Lieu T, Jensen DD, Chambers J, Dixon PH et al. Apr,. Prognostic and mechanistic potential of progesterone sulfates in intrahepatic cholestasis of pregnancy and pruritus gravidarum, Hepatology, vol. 63, no. 4, pp. 1287-98, 2016.
19.
Du Q, Pan Y, Zhang Y, Zhang H, Zheng Y, Lu L et al. Placental gene-expression profiles of intrahepatic cholestasis of pregnancy reveal involvement of multiple molecular pathways in blood vessel formation and inflammation. BMC Med Genomics, vol. 7, pp. 42, Jul 7, 2014.
20.
Sticova E, Jirsa M, Pawlowska J. New Insights in Genetic Cholestasis: From Molecular Mechanisms to Clinical Implications, Can J Gastroenterol Hepatol, vol. 2018, pp. 2313675, 2018.
21.
Niemyjska-Dmoch W, Kosinski P, Wegrzyn P, Luterek K, Jezela-Stanek A. Intrahepatic cholestasis of pregnancy and theory of inheritance of the disease. Literature review, J Matern Fetal Neonatal Med, vol. 36, no. 2, pp. 2279020, Dec, 2023.
22.
Gao XX, Ye MY, Liu Y, Li JY, Li L, Chen W et al. Prevalence and risk factors of intrahepatic cholestasis of pregnancy in a Chinese population. Sci Rep, vol. 10, no. 1, pp. 16307, Oct 1, 2020.
23.
Smith DD, Rood KM. Intrahepatic Cholestasis of Pregnancy, Clin Obstet Gynecol, vol. 63, no. 1, pp. 134–151, Mar, 2020.
24.
Crocenzi FA, Mottino AD, Cao J, Veggi LM, Pozzi EJ, Vore M et al. Aug,. Estradiol-17beta-D-glucuronide induces endocytic internalization of Bsep in rats, Am J Physiol Gastrointest Liver Physiol, vol. 285, no. 2, pp. G449-59, 2003.
25.
Germain AM, Kato S, Carvajal JA, Valenzuela GJ, Valdes GL, Glasinovic JC. Bile acids increase response and expression of human myometrial oxytocin receptor, Am J Obstet Gynecol, vol. 189, no. 2, pp. 577 – 82, Aug, 2003.
26.
Ovadia C, Seed PT, Sklavounos A, Geenes V, Di Ilio C, Chambers J et al. Association of adverse perinatal outcomes of intrahepatic cholestasis of pregnancy with biochemical markers: results of aggregate and individual patient data meta-analyses, Lancet, vol. 393, no. 10174, pp. 899–909, Mar 2, 2019.
27.
28.
Campos GA, Guerra FA, Israel EJ. Effects of cholic acid infusion in fetal lambs, Acta Obstet Gynecol Scand, vol. 65, no. 1, pp. 23 – 6, 1986.
29.
Williamson C, Geenes V. Intrahepatic cholestasis of pregnancy, Obstet Gynecol, vol. 124, no. 1, pp. 120–133, Jul, 2014.
30.
Miragoli M, Kadir SH, Sheppard MN, Salvarani N, Virta M, Wells S et al. Oct,. A protective antiarrhythmic role of ursodeoxycholic acid in an in vitro rat model of the cholestatic fetal heart, Hepatology, vol. 54, no. 4, pp. 1282-92, 2011.
31.
Zhan Y, Xu T, Chen T, Deng X, Kong Y, Li Y et al. Aug,. Intrahepatic cholestasis of pregnancy and fetal cardiac dysfunction: a systematic review and meta-analysis, Am J Obstet Gynecol MFM, vol. 5, no. 8, pp. 100952, 2023.
32.
Sepulveda WH, Gonzalez C, Cruz MA, Rudolph MI. Vasoconstrictive effect of bile acids on isolated human placental chorionic veins. Eur J Obstet Gynecol Reprod Biol, vol. 42, no. 3, pp. 211–5, Dec 13, 1991.
33.
Saleh MM, Abdo KR. Consensus on the management of obstetric cholestasis: National UK survey, BJOG, vol. 114, no. 1, pp. 99–103, Jan, 2007.
34.
Yang J, Chen C, Liu M, Zhang S. Women successfully treated for severe intrahepatic cholestasis of pregnancy do not have increased risks for adverse perinatal outcomes, Medicine (Baltimore), vol. 98, no. 27, pp. e16214, Jul, 2019.
Metadata
Title
Maternal and neonatal outcomes of intrahepatic cholestasis of pregnancy after in vitro fertilization
Authors
Ying Zhu
Le Xu
Rajluxmee Beejadhursing
Fei Li
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2024
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-024-06248-x

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