UKOSS Update


Association of severe intrahepatic cholestasis of pregnancy with adverse pregnancy outcomes[1]

  • Previous retrospective case series have suggested that intrahepatic cholestasis of pregnancy (ICP) is associated with adverse fetal outcomes, but there have been concerns over possible biases in these studies.
  • The aim of this study was to describe the pregnancy complications in a national cohort of women with severe ICP and to compare these with pregnancy complications in a cohort of unaffected women and with national rates where available.
  • 713 confirmed cases of severe ICP were identified, giving an estimated incidence of 9.2 cases per 10 000 maternities.
  • Women with a singleton pregnancy affected by severe ICP (n = 669) had increased odds of preterm delivery (adjusted odds ratio [aOR] 5.39, 95% CI 4.17–6.98), neonatal unit admission (aOR 2.68, 95% CI 1.97–3.65) and stillbirth (aOR 2.58, 95% CI 1.03–6.49) compared to control women, and these risks rose with increasing maternal serum bile acid concentrations.
  • Seven of the ten stillbirths in ICP cases were associated with co-existing pregnancy complications.
  • The risks of preterm delivery (both spontaneous and iatrogenic) and stillbirth were also raised when compared with national data.
  • These findings support the case for close antenatal monitoring of pregnancies affected by severe ICP.


Thank you to all members who contributed information to this study.

Further information

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