TOPLINE:

In a cohort of 104 patients with intrahepatic cholestasis of pregnancy (ICP), 44% experienced recurrence in subsequent pregnancies, with peak total bile acid levels > 40 μM/L in the index pregnancy significantly associated with recurrence risk. A shorter interpregnancy interval was linked to lower recurrence risk, while Hispanic patients showed higher recurrence rates.

METHODOLOGY:

• Researchers conducted a retrospective cohort study of 104 patients with singleton, nonanomalous live births at an academic center in Queens, New York, between 2015 and 2024.
• Analysis included patients with ICP in an index pregnancy who received care during subsequent pregnancy at the institution, excluding those with documented ICP before the index pregnancy.
• Primary outcome measure focused on ICP recurrence in subsequent pregnancy, whereas secondary analysis evaluated associations between candidate risk factors and recurrence.
• Statistical analysis employed χ² or Wilcoxon rank-sum tests for continuous measures, and Fisher exact tests for categorical measures, with univariable logistic regression presented as odds ratios (ORs) and 95% CIs.

TAKEAWAY:

• Those with peak total bile acid levels exceeding 40 μM/L in index pregnancy showed significantly higher recurrence rates (30.4%; 95% CI, 17.7%-45.8% vs 6.9%; 95% CI, 1.9%-16.7%; P < .01).
• Hispanic patients demonstrated higher recurrence rates (84.8%; 95% CI, 71.1%-93.7% vs 65.5%; 95% CI, 51.9%-77.5%; P = .03).
• Patients with recurrent ICP had higher median peak total bile acid levels in the index pregnancy than those who did not have recurrent ICP (22.1 μM/L; interquartile range [IQR], 14.6-42.1 vs 15.3 μM/L; IQR, 10.9-23.0).
• Short interpregnancy interval (< 18 months) was associated with decreased odds of ICP recurrence (OR, 0.39; 95% CI, 0.16-0.91).

IN PRACTICE:

“These findings contribute to the literature on the risk of ICP recurrence in a modern, racially diverse cohort and highlight elevated TBA [total bile acid] level as a predictor of recurrence,” the authors of the study wrote.

SOURCE:

The study was led by Henri M. Rosenberg, MD, Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai in New York City. It was published online in Obstetrics & Gynecology.

LIMITATIONS:

The retrospective design and absence of data on family history of ICP or ICP genetic testing limited the study’s scope. The researchers noted underrepresentation of non-Hispanic White, Black, and Asian patients in the study population, affecting generalizability. The small sample size prevented multivariable modeling with adjustment for confounders, and the authors cautioned that the wide CIs suggest additional studies with larger sample sizes are warranted.

DISCLOSURES:

The authors did not report any potential conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.