Effect of Intrahepatic Cholestasis of Pregnancy on Neonatal Birth Weight: A Meta-Analysis

Objective: To evaluate the effect of intrahepatic cholestasis of pregnancy (ICP) on neonatal birth weight. Methods: Potential articles were identified by searching PubMed and Web of Science databases on April 30th, 2017. Using the Mantel-Haenszel random-effects or fixed-effects model, outcomes were summarized through weighted mean difference (WMD) and 95% confidence intervals (CI). Potential publication bias was tested using a funnel plot and the methods of Egger’s regression and Begg’s test. Results: A total of eight studies were included in our meta-analysis. Six studies reported data on neonatal birth weight in ICP and control pregnancies. Pooled data from the six studies showed that the birth weight in the ICP group was significantly lighter than in the control group. The overall pooled WMD was -175 g (95% CI: -301, -48). Meanwhile, pooled data from the other two studies indicated that the birth weight in the late-onset ICP group was heavier than in the early-onset ICP group (WMD: 267 g, 95% CI: 168, 366). Conclusion: Neonatal birth weights in ICP pregnancies were lower than in normal pregnancies. Furthermore, early-onset ICP is associated with a lower birth weight than late-onset ICP.

[1]  D. Fan,et al.  The Incidence of Postpartum Hemorrhage in Pregnant Women with Placenta Previa: A Systematic Review and Meta-Analysis , 2017, PloS one.

[2]  Yi Li,et al.  The Relationship between Maternal Gestational Impaired Glucose Tolerance and Risk of Large-for-Gestational-Age Infant: A Meta-Analysis of 14 Studies , 2016, Journal of clinical research in pediatric endocrinology.

[3]  A. Kırbaş,et al.  Maternal and fetal serum levels of caspase-cleaved fragments of cytokeratin-18 in intrahepatic cholestasis of pregnancy , 2016, The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians.

[4]  Yvonne W. Cheng,et al.  Intrahepatic cholestasis of pregnancy and timing of delivery , 2015, The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians.

[5]  J. Lam,et al.  Intrahepatic cholestasis of pregnancy: maternal and fetal outcomes associated with elevated bile acid levels. , 2015, American journal of obstetrics and gynecology.

[6]  Guo-wei Zhang,et al.  Risk factors for adverse fetal outcomes among women with early‐ versus late‐onset intrahepatic cholestasis of pregnancy , 2015, International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics.

[7]  J. Marin,et al.  Effect of ursodeoxycholic acid treatment on the altered progesterone and bile acid homeostasis in the mother-placenta-foetus trio during cholestasis of pregnancy. , 2015, British journal of clinical pharmacology.

[8]  C. Raker,et al.  The Metabolic Profile of Intrahepatic Cholestasis of Pregnancy Is Associated With Impaired Glucose Tolerance, Dyslipidemia, and Increased Fetal Growth , 2014, Diabetes Care.

[9]  C. Raker,et al.  Intrahepatic cholestasis of pregnancy is associated with an increased risk of gestational diabetes. , 2014, European journal of obstetrics, gynecology, and reproductive biology.

[10]  M. Jarvelin,et al.  Maternal cholestasis during pregnancy programs metabolic disease in offspring. , 2013, The Journal of clinical investigation.

[11]  T. Maciejewski,et al.  The concentrations of bile acids and erythropoietin in pregnant women with intrahepatic cholestasis and the state of the fetus and newborn. , 2013, Medycyna wieku rozwojowego.

[12]  J. Ludvigsson,et al.  Intrahepatic cholestasis of pregnancy and associated adverse pregnancy and fetal outcomes: a 12‐year population‐based cohort study , 2013, BJOG : an international journal of obstetrics and gynaecology.

[13]  I. Usta,et al.  A Clinical Approach to Intrahepatic Cholestasis of Pregnancy , 2013, American Journal of Perinatology.

[14]  A. Caughey,et al.  Fetal Outcomes in Pregnancies Complicated by Intrahepatic Cholestasis of Pregnancy in a Northern California Cohort , 2012, PloS one.

[15]  R. Žalinkevičius,et al.  Pregnancy outcome in cases of intrahepatic cholestasis of pregnancy , 2011, International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics.

[16]  A. Stang Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses , 2010, European Journal of Epidemiology.

[17]  L. Kupčinskas,et al.  Predictors of premature delivery in patients with intrahepatic cholestasis of pregnancy. , 2007, World journal of gastroenterology.

[18]  M. Saleh,et al.  Intrahepatic cholestasis of pregnancy: review of the literature and evaluation of current evidence. , 2007, Journal of women's health.

[19]  T. Pusl,et al.  Intrahepatic cholestasis of pregnancy , 2007, Orphanet journal of rare diseases.

[20]  T. Goodwin,et al.  Intrahepatic cholestasis of pregnancy: perinatal outcome associated with expectant management. , 1996, American journal of obstetrics and gynecology.

[21]  J. Ribalta,et al.  PREVALENCE OF INTRAHEPATIC CHOLESTASIS OF PREGNANCY IN CHILE , 1978, Annals of internal medicine.

[22]  M. Özeren,et al.  Intrahepatic cholestasis of pregnancy may lead to low birth weight. , 2015, Turkish journal of medical sciences.

[23]  Xin Luo,et al.  [Analysis of clinical characteristics and perinatal outcome of early-onset intrahepatic cholestasis of pregnancy]. , 2013, Zhonghua fu chan ke za zhi.

[24]  Yi-Ling Ding,et al.  [Relationship of fetal total bile acid and the change of fetal pancreas endocrine secretion and its impact on fetal growth and development in intrahepatic cholestasis of pregnancy]. , 2009, Zhonghua fu chan ke za zhi.

[25]  P. Rinaldo,et al.  Liver disease in pregnancy. , 1997, The New England journal of medicine.

[26]  J. Ribalta,et al.  Prevalence of intrahepatic cholestasis of pregnancy in La Paz, Bolivia. , 1979, Journal of chronic diseases.