Perinatal outcomes associated with ICP in twin pregnancies were worse than singletons: an almost 5-year retrospective cohort study
Abstract Background Intrahepatic cholestasis of pregnancy (ICP) is associated with an increased risk of adverse perinatal outcomes leading to high perinatal morbidity and mortality. However, few studies have examined twin pregnancies complicated by ICP. To assess the perinatal outcomes of twin pregn...
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| Format: | Article |
| Language: | English |
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BMC
2022-11-01
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| Series: | BMC Pregnancy and Childbirth |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12884-022-05160-6 |
| _version_ | 1828309990779125760 |
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| author | Tingting Xu Chunyan Deng Yongchi Zhan Qing Hu Guiqiong Huang Xing Wang Bing Guo Haiyan Yu Xiaodong Wang |
| author_facet | Tingting Xu Chunyan Deng Yongchi Zhan Qing Hu Guiqiong Huang Xing Wang Bing Guo Haiyan Yu Xiaodong Wang |
| author_sort | Tingting Xu |
| collection | DOAJ |
| description | Abstract Background Intrahepatic cholestasis of pregnancy (ICP) is associated with an increased risk of adverse perinatal outcomes leading to high perinatal morbidity and mortality. However, few studies have examined twin pregnancies complicated by ICP. To assess the perinatal outcomes of twin pregnancies with ICP, a retrospective cohort study was conducted. Methods A total of 633 twin pregnancies and 1267 singleton pregnancies with ICP were included. In addition, a correlation study was performed on the matched total bile acid (TBA) levels from maternal serum, fetal umbilical venous blood, and amniotic fluid of 33 twin pregnancies from twin groups. Results When compared to singletons, twin pregnancies with ICP had a higher risk of cesarean section (CS) (96.4% vs. 76.1%), preterm birth (PTB) (82.6% vs. 19.7%), fetal distress (2.0% vs. 1.3%), and neonatal intensive care unit (NICU) admission (23.6% vs. 5.1%), which was significantly related to increasing TBA levels (P < 0.05). In twin pregnancies with TBA ≥100 μmol/L, the incidences of CS, PTB, fetal distress, neonatal asphyxia, and meconium-stained amniotic fluid were 94.4, 100, 11.1, 5.6, and 36.1%, respectively. Furthermore, the maximum maternal TBA levels were positively correlated with TBA levels in the amniotic fluid (r = 0.61, P < 0.05) and umbilical cord blood (r = 0.44, P < 0.05), and a similar correlation was found for maternal TBA levels at delivery. TBA levels in umbilical cord blood and amniotic fluid also had a significant and positive correlation (r = 0.52, P < 0.05). Conclusions Twin pregnancies with ICP had a higher risk for adverse perinatal outcomes than singletons, which was associated with higher TBA levels. TBA can be transported through the placenta and is involved in uterus-placenta-fetal circulation. |
| first_indexed | 2024-04-13T15:36:19Z |
| format | Article |
| id | doaj.art-2761fb2c577e47339d7b48317017aba4 |
| institution | Directory Open Access Journal |
| issn | 1471-2393 |
| language | English |
| last_indexed | 2024-04-13T15:36:19Z |
| publishDate | 2022-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj.art-2761fb2c577e47339d7b48317017aba42022-12-22T02:41:15ZengBMCBMC Pregnancy and Childbirth1471-23932022-11-0122111010.1186/s12884-022-05160-6Perinatal outcomes associated with ICP in twin pregnancies were worse than singletons: an almost 5-year retrospective cohort studyTingting Xu0Chunyan Deng1Yongchi Zhan2Qing Hu3Guiqiong Huang4Xing Wang5Bing Guo6Haiyan Yu7Xiaodong Wang8Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan UniversityDepartment of Obstetrics and Gynecology, West China Second University Hospital, Sichuan UniversityDepartment of Obstetrics and Gynecology, West China Second University Hospital, Sichuan UniversityDepartment of Obstetrics and Gynecology, West China Second University Hospital, Sichuan UniversityDepartment of Obstetrics and Gynecology, West China Second University Hospital, Sichuan UniversityWest China School of Public Health and West China Fourth Hospital, Sichuan UniversityWest China School of Public Health and West China Fourth Hospital, Sichuan UniversityDepartment of Obstetrics and Gynecology, West China Second University Hospital, Sichuan UniversityDepartment of Obstetrics and Gynecology, West China Second University Hospital, Sichuan UniversityAbstract Background Intrahepatic cholestasis of pregnancy (ICP) is associated with an increased risk of adverse perinatal outcomes leading to high perinatal morbidity and mortality. However, few studies have examined twin pregnancies complicated by ICP. To assess the perinatal outcomes of twin pregnancies with ICP, a retrospective cohort study was conducted. Methods A total of 633 twin pregnancies and 1267 singleton pregnancies with ICP were included. In addition, a correlation study was performed on the matched total bile acid (TBA) levels from maternal serum, fetal umbilical venous blood, and amniotic fluid of 33 twin pregnancies from twin groups. Results When compared to singletons, twin pregnancies with ICP had a higher risk of cesarean section (CS) (96.4% vs. 76.1%), preterm birth (PTB) (82.6% vs. 19.7%), fetal distress (2.0% vs. 1.3%), and neonatal intensive care unit (NICU) admission (23.6% vs. 5.1%), which was significantly related to increasing TBA levels (P < 0.05). In twin pregnancies with TBA ≥100 μmol/L, the incidences of CS, PTB, fetal distress, neonatal asphyxia, and meconium-stained amniotic fluid were 94.4, 100, 11.1, 5.6, and 36.1%, respectively. Furthermore, the maximum maternal TBA levels were positively correlated with TBA levels in the amniotic fluid (r = 0.61, P < 0.05) and umbilical cord blood (r = 0.44, P < 0.05), and a similar correlation was found for maternal TBA levels at delivery. TBA levels in umbilical cord blood and amniotic fluid also had a significant and positive correlation (r = 0.52, P < 0.05). Conclusions Twin pregnancies with ICP had a higher risk for adverse perinatal outcomes than singletons, which was associated with higher TBA levels. TBA can be transported through the placenta and is involved in uterus-placenta-fetal circulation.https://doi.org/10.1186/s12884-022-05160-6Intrahepatic cholestasis of pregnancyTwin pregnanciesRetrospective cohort studyPerinatal outcomes |
| spellingShingle | Tingting Xu Chunyan Deng Yongchi Zhan Qing Hu Guiqiong Huang Xing Wang Bing Guo Haiyan Yu Xiaodong Wang Perinatal outcomes associated with ICP in twin pregnancies were worse than singletons: an almost 5-year retrospective cohort study BMC Pregnancy and Childbirth Intrahepatic cholestasis of pregnancy Twin pregnancies Retrospective cohort study Perinatal outcomes |
| title | Perinatal outcomes associated with ICP in twin pregnancies were worse than singletons: an almost 5-year retrospective cohort study |
| title_full | Perinatal outcomes associated with ICP in twin pregnancies were worse than singletons: an almost 5-year retrospective cohort study |
| title_fullStr | Perinatal outcomes associated with ICP in twin pregnancies were worse than singletons: an almost 5-year retrospective cohort study |
| title_full_unstemmed | Perinatal outcomes associated with ICP in twin pregnancies were worse than singletons: an almost 5-year retrospective cohort study |
| title_short | Perinatal outcomes associated with ICP in twin pregnancies were worse than singletons: an almost 5-year retrospective cohort study |
| title_sort | perinatal outcomes associated with icp in twin pregnancies were worse than singletons an almost 5 year retrospective cohort study |
| topic | Intrahepatic cholestasis of pregnancy Twin pregnancies Retrospective cohort study Perinatal outcomes |
| url | https://doi.org/10.1186/s12884-022-05160-6 |
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