Aylin Yılmaz, Didar Kurt
Southern Clinics of Istanbul Eurasia - 2025;36(4):317-322
Objective: This study aimed to evaluate the incidence of neonatal acidemia and its association with fasting bile acid levels in pregnancies diagnosed with intrahepatic cholestasis. Methods: This retrospective cohort study included pregnant women who delivered at the Department of Obstetrics and Gynecology of our institution between January 2020 and March 2025. Patients diagnosed with intrahepatic cholestasis of pregnancy (ICP) were enrolled. Maternal and neonatal data were collected from hospital records, including demographic characteristics, laboratory values, treatment regimens, delivery details, and neonatal outcomes. Statistical analysis was conducted using SPSS version 24.0. Results: A total of 58 women with intrahepatic cholestasis of pregnancy (ICP) were included. Based on serum bile acid levels at diagnosis, patients were divided into two groups: <40 µmol/L (n=41) and >=40 µmol/L (n=17). No significant differences were observed between the groups regarding maternal demographics, gestational age, birth weight, or history of ICP (p>0.05). Preterm birth rates were similar in both groups (48.8% vs. 47.1%, p=1.000). NICU admissions were more common in the >=40 µmol/L group (70.6% vs. 53.7%), but not statistically significant (p=0.36). Incidences of neonatal jaundice, tachypnea, and respiratory distress syndrome showed no significant group differences (p>0.05). Neonatal acidemia, defined as umbilical cord pH <7.20 or <7.10, occurred at comparable rates across both bile acid groups, without statistically significant differences. The mean pH was 7.29+/-0.11 in the <40 µmol/L group and 7.28+/-0.11 in the >=40 µmol/L group (p=0.856). No correlation was observed between maternal bile acid levels and neonatal umbilical cord pH (r=-0.02, p=0.884). Conclusion: No significant association was found between maternal bile acid levels and neonatal acidemia. Further prospective studies are needed to clarify this relationship in intrahepatic cholestasis of pregnancy.
