Meta-analyses in cholestatic pregnancy; the outstanding clinical questions: Meta-analyses in ICP and beyond

Caroline Ovadia Ovadia; Nadejda Capatina

Meta-analyses in cholestatic pregnancy; the outstanding clinical questions: Meta-analyses in ICP and beyond

Caroline Ovadia Ovadia, Nadejda Capatina

Women & Children's Health

Research output: Contribution to journal › Review article › peer-review

Abstract

Reports of adverse pregnancy outcomes associated with maternal pruritus and liver impairment have circulated since the 1800’s, yet the precise diagnosis and management of intrahepatic cholestasis of pregnancy have varied markedly. Recent evidence, including that from individual participant data meta-analyses, has provided an evidence-base that brings us closer to standardised, and optimal, management of the condition. Based upon increased adverse perinatal outcomes with higher bile acid concentrations, disease management should be according to severity (defined by peak bile acid concentration) in order to recommend appropriate gestation of birth. Similarly, the reduced spontaneous preterm birth rate for patients receiving ursodeoxycholic acid treatment suggest potential benefit for treatment of patients with moderate-severe disease.

Original language	English
Journal	Obstetric Medicine
Publication status	Accepted/In press - 11 Apr 2024

Keywords

intrahepatic cholestasis of pregnancy
preterm birth
meta-analysis
bile acid
stillbirth

Embargoed Document

ICP metanalaysis summary paper_revised_12_3_24_clean copy
Accepted author manuscript, 45.6 KB
Licence: Unspecified
Embargo ends: 1/11/2024

Cite this

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title = "Meta-analyses in cholestatic pregnancy; the outstanding clinical questions: Meta-analyses in ICP and beyond",

abstract = "Reports of adverse pregnancy outcomes associated with maternal pruritus and liver impairment have circulated since the 1800{\textquoteright}s, yet the precise diagnosis and management of intrahepatic cholestasis of pregnancy have varied markedly. Recent evidence, including that from individual participant data meta-analyses, has provided an evidence-base that brings us closer to standardised, and optimal, management of the condition. Based upon increased adverse perinatal outcomes with higher bile acid concentrations, disease management should be according to severity (defined by peak bile acid concentration) in order to recommend appropriate gestation of birth. Similarly, the reduced spontaneous preterm birth rate for patients receiving ursodeoxycholic acid treatment suggest potential benefit for treatment of patients with moderate-severe disease. ",

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AU - Ovadia, Caroline Ovadia

AU - Capatina, Nadejda

PY - 2024/4/11

Y1 - 2024/4/11

N2 - Reports of adverse pregnancy outcomes associated with maternal pruritus and liver impairment have circulated since the 1800’s, yet the precise diagnosis and management of intrahepatic cholestasis of pregnancy have varied markedly. Recent evidence, including that from individual participant data meta-analyses, has provided an evidence-base that brings us closer to standardised, and optimal, management of the condition. Based upon increased adverse perinatal outcomes with higher bile acid concentrations, disease management should be according to severity (defined by peak bile acid concentration) in order to recommend appropriate gestation of birth. Similarly, the reduced spontaneous preterm birth rate for patients receiving ursodeoxycholic acid treatment suggest potential benefit for treatment of patients with moderate-severe disease.

AB - Reports of adverse pregnancy outcomes associated with maternal pruritus and liver impairment have circulated since the 1800’s, yet the precise diagnosis and management of intrahepatic cholestasis of pregnancy have varied markedly. Recent evidence, including that from individual participant data meta-analyses, has provided an evidence-base that brings us closer to standardised, and optimal, management of the condition. Based upon increased adverse perinatal outcomes with higher bile acid concentrations, disease management should be according to severity (defined by peak bile acid concentration) in order to recommend appropriate gestation of birth. Similarly, the reduced spontaneous preterm birth rate for patients receiving ursodeoxycholic acid treatment suggest potential benefit for treatment of patients with moderate-severe disease.

KW - intrahepatic cholestasis of pregnancy

KW - preterm birth

KW - meta-analysis

KW - bile acid

KW - stillbirth

M3 - Review article

SN - 1753-495X

JO - Obstetric Medicine

JF - Obstetric Medicine

ER -

Meta-analyses in cholestatic pregnancy; the outstanding clinical questions: Meta-analyses in ICP and beyond

Abstract

Keywords

Embargoed Document

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