Prevalence of intrahepatic cholestasis of pregnancy and its association with gestational diabetes in an urban population in Hungary

Introduction: Intrahepatic cholestasis of pregnancy is the most common pregnancy-induced liver disease characterized by the presence of pruritus, elevated liver enzymes and serum total bile acid levels. Intrahepatic cholestasis of pregnancy is associated with increased neonatal morbidity and mortality. Objective: This study was aimed to determine the prevalence and obstetric and demographic risk factors of pruritus and intrahepatic cholestasis in pregnancy and its association with pregnancy-induced disorders.
Methods: Pregnant women managed for pruritus in pregnancy at the Maternal-Fetal Out-Patient Clinic of our Department between January 1, 2019 and June 30, 2021 were enrolled. Analysis of the association between intrahe patic cholestasis and demographic and obstetric variables as well as pregnancy-induced disorders was performed by the comparison of frequencies in cases and their matched controls.
Results: During the study period, overall, 5827 pregnant women gave birth in our Department, of whom 105 (1.8%) women were diagnosed with newly onset pruritus in pregnancy: 88 (1.5%) pregnant women with pruritus had elevated liver enzyme levels, and further 17 (0.3%) had also abnormal total bile acid levels. The presence of pruritus and development of intrahepatic cholestasis was independent of maternal age, the number of previous pregnancies, and the meteorologic season when the diagnosis was made. The frequency of gestational diabetes (16.2%) among women diagnosed with intrahepatic cholestasis was significantly higher than that in the total parturient population (8.3%) or in their matched controls (6.7%) (p<0.05 and p<0.05). No significant correlation was found between pruritus or intrahepatic cholestasis and gestational hypertension, intrauterine growth restriction or macrosomia.
Conclusion: Our data suggest that the prevalence of intrahepatic cholestasis of pregnancy in Hungary is similar to that reported from other European countries and is associated with gestational diabetes