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| Correlation between the serum total bile acid level of women with intrahepatic cholestasis of pregnancy and their fetal distress and its value for predicting the hypoxia degree of their fetuses |
| The First Hospital of Wuhu, Anhui Province, 241000 |
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Abstract To investigate the correlation between the serum total bile acid level of pregnant women with intrahepatic cholestasis of pregnancy (ICP) and their fetal distress, and to study its value for predicting the hypoxia degree of their fetuses. Methods: 98 single pregnant women with ICP treated from January 2016 to January 2020 were collected in study group retrospectively. These women were divided in group A (71 cases with fetal mild asphyxia) and group B (27 cases with fetal severe asphyxia) according to the l min Apgar score of the newborns. 50 normal pregnant women who underwent physical examination were selected in control group during the same period. All the women with ICP were given symptomatic treatment after admission. The serum levels of total bile acids in peripheral venous blood and femoral venous blood of the newborns within 48 hours after birth were detected by automatic biochemical analyzer. Multiple linear regression analysis was used to analyze the correlation. Receiver operating characteristic (ROC) curve was used to evaluate the diagnostic effect. Results: The serum total bile acid level (23.16±5.26 mmol/L) of the women in the study group was significantly higher than that (1.92±0.03mmol/L) of the women in the control group, and the serum total bile acid level (17.39±7.43 mmol/L) of the women in group B was significantly higher than that (12.09±4.06 mmol/L) of the women in group A (all P＜0.05). Multiple linear regression analysis showed that the serum total bile acid level of the pregnant women with ICP was positively correlated with the occurrence of their fetal intrauterine distress (P＜0.05). The area under the curve of the serum total bile acid level of the pregnant women with ICP for diagnosing their fetal degree of intrauterine hypoxia was 0.800 (95%CI 0.693-0.907), and the diagnostic critical value, the sensitivity, the specificity, and the accuracy of which were 18.107 mmol/L, 60.0%, 92.6%, and 82.7%, respectively. Conclusion: The level of serum total bile acid of the pregnant women with ICP increases abnormally, which is positive correlation with their fetal intrauterine distress and has high specificity for diagnosing their fetal intrauterine hypoxia. The serum total bile acids level of the newborns with fetal severe asphyxia is significantly higher than that of the newborns with fetal mild asphyxia.
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