The Incidence of Intrahepatic Cholestasis of Pregnancy and its Maternal, Fetal, and Neonatal Adverse Outcomes: A Systematic Review and Meta‐Analysis

Introduction Intrahepatic cholestasis of pregnancy (ICP) is a problem with an increasing incidence and negative maternal, fetal, and neonatal consequences. This problem is becoming increasingly important. This systematic review and meta‐analysis aimed to determine the incidence of ICP and its advers...

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Bibliographic Details
Published in:Journal of midwifery & women's health 2024-05, Vol.69 (3), p.370-382
Main Authors: Odabaş, Resmiye Kaya, Sökmen, Yasemin, Dünder, Emre, Taşpınar, Ayten
Format: Article
Language:English
Subjects:
Adverse
Analysis
Birth weight
Childbirth & labor
Cholestasis
Clinical outcomes
fetal
Gallbladder diseases
Gestational age
Hypertension
Intensive care
intrahepatic cholestasis
maternal
Medical personnel
Meta-analysis
midwifery
Midwives
neonatal
Neonatal units
Newborn babies
obstetric cholestasis
Perinatal
Pregnancy
pregnant
Premature birth
Prenatal care
Quality assessment
Systematic review
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Summary:Introduction Intrahepatic cholestasis of pregnancy (ICP) is a problem with an increasing incidence and negative maternal, fetal, and neonatal consequences. This problem is becoming increasingly important. This systematic review and meta‐analysis aimed to determine the incidence of ICP and its adverse maternal, fetal, and neonatal adverse outcomes based on primary research studies. Methods This systematic review and meta‐analysis used Preferred Reporting Items for Systematic Reviews and Meta‐Analyses reporting guidelines and was conducted between June and September 2023 using the following keywords: obstetric cholestasis OR intrahepatic cholestasis AND pregnancy OR pregnant OR prenatal OR antenatal OR perinatal OR maternal OR fetal OR neonatal. Quality assessment of the studies was performed using the Critical Appraisal Checklists developed by the JBI Institute. Data were synthesized using meta‐analysis methods. Results The analysis included 10 studies published between 2013 and 2023. The meta‐analysis showed that the incidence of ICP was 1.7% (odds ratio [OR], 0.021; 95% CI, 0.012‐0.027), whereas maternal, fetal, and neonatal adverse outcomes included cesarean birth (OR, 2.938; 95% CI, 1.467‐5.881), preterm birth or preterm prelabor rupture of membranes (OR, 4.241; 95% CI, 1.996‐9.009), hypertensive disorders of pregnancy (OR, 3.715; 95% CI, 1.545‐8.929), maternal infection (OR, 3.301; 95% CI, 2.917‐3.737), neonatal intensive care unit admission (OR, 2.715; 95% CI, 1.458‐5.056), birth weight less than or equal to 2500 g (OR, 2.518; 95% CI, 1.296‐4.892), and small for gestational age (OR, 1.915; 95% CI, 1.424‐2.573). Discussion This systematic review and meta‐analysis revealed that ICP has a high incidence and several maternal, fetal, and neonatal adverse outcomes. Therefore, midwives and other health professionals must be aware of these outcomes and provide appropriate care to pregnant individuals with ICP.
ISSN:1526-9523
1542-2011
1542-2011
DOI:10.1111/jmwh.13640