Correlation between serum levels of bile acids in pregnant women with intrahepatic cholestasis of pregnancy and condition of their newborns

OBJECTIVES: The aim of the study was to determine a relation between the level of total serum bile acids in pregnant women and the condition of their newborns on the basis of select parameters of acid-base balance in the cord blood. MATERIAL AND METHODS: The study group consisted of 64 pregnant women with Intrahepatic Cholestasis of Pregnancy and 78 healthy pregnant women constituted the control group. Colorimetric enzymatic measurements of serum total bile acids were performed in both groups. RESULTS: In the mild cholestasis group, mean concentration of bile acids amounted to 20.6 +/- 1.0 micromol/l and was statistically significantly lower as compared to women with severe cholestasis (58.9 +/- 9.5 micromol/l). In the control group, mean concentration of bile acids was 4.1 +/- 0.3 micromol/l and was statistically significantly lower as compared to groups with cholestasis. Caesarean section was performed in 60.9% of women with cholestasis as compared to 19.2% of controls. Also, neonatal condition in the first minute of life was worse in the group with cholestasis as compared to the infants in the control group. The body weight of newborns of mothers with cholestasis was statistically significantly lower than in infants born to controls. Lowered neonatal pH (below 7.20) was noted in 2.6% of the newborns from the control group and was statistically significantly less frequent as compared to infants from the group with cholestasis. CONCLUSIONS: Periodic measurements of total bile acid concentrations in serum of pregnant women with cholestasis is of high value in establishing the diagnosis and determining severity of the disease in the mother as well as potential hazard for the fetus. Simultaneous monitoring of the changes total bile acids concentrations in the blood serum and the well-being allows to reduce the rates of neonatal distresses after birth and cesarean sections.