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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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| Published in: | Journal of midwifery & women's health 2024-05, Vol.69 (3), p.370-382 |
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| creator | Odabaş, Resmiye Kaya Sökmen, Yasemin Dünder, Emre Taşpınar, Ayten |
| description | 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. |
| doi_str_mv | 10.1111/jmwh.13640 |
| format | article |
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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.</description><identifier>ISSN: 1526-9523</identifier><identifier>ISSN: 1542-2011</identifier><identifier>EISSN: 1542-2011</identifier><identifier>DOI: 10.1111/jmwh.13640</identifier><identifier>PMID: 38750666</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>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</subject><ispartof>Journal of midwifery & women's health, 2024-05, Vol.69 (3), p.370-382</ispartof><rights>2024 by the American College of Nurse‐Midwives.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3570-830d74f9c87f87fb29991e933436a9ff5b4fd73979692469e8f50ad7ff36d3c53</citedby><cites>FETCH-LOGICAL-c3570-830d74f9c87f87fb29991e933436a9ff5b4fd73979692469e8f50ad7ff36d3c53</cites><orcidid>0000-0002-4470-0231 ; 0000-0003-0230-8968 ; 0000-0001-7918-2457 ; 0000-0003-0044-4173</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fjmwh.13640$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fjmwh.13640$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>315,786,790,27957,27958,31034,50923,51032</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38750666$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Odabaş, Resmiye Kaya</creatorcontrib><creatorcontrib>Sökmen, Yasemin</creatorcontrib><creatorcontrib>Dünder, Emre</creatorcontrib><creatorcontrib>Taşpınar, Ayten</creatorcontrib><title>The Incidence of Intrahepatic Cholestasis of Pregnancy and its Maternal, Fetal, and Neonatal Adverse Outcomes: A Systematic Review and Meta‐Analysis</title><title>Journal of midwifery & women's health</title><addtitle>J Midwifery Womens Health</addtitle><description>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.</description><subject>Adverse</subject><subject>Analysis</subject><subject>Birth weight</subject><subject>Childbirth & labor</subject><subject>Cholestasis</subject><subject>Clinical outcomes</subject><subject>fetal</subject><subject>Gallbladder diseases</subject><subject>Gestational age</subject><subject>Hypertension</subject><subject>Intensive care</subject><subject>intrahepatic cholestasis</subject><subject>maternal</subject><subject>Medical personnel</subject><subject>Meta-analysis</subject><subject>midwifery</subject><subject>Midwives</subject><subject>neonatal</subject><subject>Neonatal units</subject><subject>Newborn babies</subject><subject>obstetric cholestasis</subject><subject>Perinatal</subject><subject>Pregnancy</subject><subject>pregnant</subject><subject>Premature birth</subject><subject>Prenatal care</subject><subject>Quality assessment</subject><subject>Systematic review</subject><issn>1526-9523</issn><issn>1542-2011</issn><issn>1542-2011</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>7QJ</sourceid><recordid>eNp9kc1O3DAQgK2qqFDopQ9QWeqlQg3YcWzH3FYrKCAWqpaqx8jrjLtZ5WdrJ6xy6yNw4gF5Euxd6KGHWpbGo_nms0aD0HtKjmg4x8tmvTiiTGTkFdqjPEuTlFD6Or5TkSiesl301vslIVQSRd6gXZZLToQQe-jhdgH4ojVVCa0B3NmQ9E4vYKX7yuDpoqvB99pXPta-OvjV6taMWLclrnqPZ7oH1-r6Mz6DPoZYuIau1SHDk_IOnAd8M_Sma8Cf4An-Pvoemo39G9xVsN60zEL345_7SVCN4bMDtGN17eHdc9xHP85Ob6fnydXNl4vp5CoxjEuS5IyUMrPK5NKGO0-VUhQUYxkTWlnL55ktJVNSCZVmQkFuOdGltJaJkhnO9tGnrXflut9DmLRoKm-grnUL3eALRjjPVcokCejHf9BlN8TRIyWYSkUuovBwSxnXee_AFitXNdqNBSVF3FYRt1VsthXgD8_KYd5A-Rd9WU8A6BZYVzWM_1EVl7Of51vpE-5hoHQ</recordid><startdate>202405</startdate><enddate>202405</enddate><creator>Odabaş, Resmiye Kaya</creator><creator>Sökmen, Yasemin</creator><creator>Dünder, Emre</creator><creator>Taşpınar, Ayten</creator><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QJ</scope><scope>ASE</scope><scope>FPQ</scope><scope>K6X</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-4470-0231</orcidid><orcidid>https://orcid.org/0000-0003-0230-8968</orcidid><orcidid>https://orcid.org/0000-0001-7918-2457</orcidid><orcidid>https://orcid.org/0000-0003-0044-4173</orcidid></search><sort><creationdate>202405</creationdate><title>The Incidence of Intrahepatic Cholestasis of Pregnancy and its Maternal, Fetal, and Neonatal Adverse Outcomes: A Systematic Review and Meta‐Analysis</title><author>Odabaş, Resmiye Kaya ; Sökmen, Yasemin ; Dünder, Emre ; Taşpınar, Ayten</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3570-830d74f9c87f87fb29991e933436a9ff5b4fd73979692469e8f50ad7ff36d3c53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adverse</topic><topic>Analysis</topic><topic>Birth weight</topic><topic>Childbirth & labor</topic><topic>Cholestasis</topic><topic>Clinical outcomes</topic><topic>fetal</topic><topic>Gallbladder diseases</topic><topic>Gestational age</topic><topic>Hypertension</topic><topic>Intensive care</topic><topic>intrahepatic cholestasis</topic><topic>maternal</topic><topic>Medical personnel</topic><topic>Meta-analysis</topic><topic>midwifery</topic><topic>Midwives</topic><topic>neonatal</topic><topic>Neonatal units</topic><topic>Newborn babies</topic><topic>obstetric cholestasis</topic><topic>Perinatal</topic><topic>Pregnancy</topic><topic>pregnant</topic><topic>Premature birth</topic><topic>Prenatal care</topic><topic>Quality assessment</topic><topic>Systematic review</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Odabaş, Resmiye Kaya</creatorcontrib><creatorcontrib>Sökmen, Yasemin</creatorcontrib><creatorcontrib>Dünder, Emre</creatorcontrib><creatorcontrib>Taşpınar, Ayten</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>British Nursing Index</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>British Nursing Index</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of midwifery & women's health</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Odabaş, Resmiye Kaya</au><au>Sökmen, Yasemin</au><au>Dünder, Emre</au><au>Taşpınar, Ayten</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Incidence of Intrahepatic Cholestasis of Pregnancy and its Maternal, Fetal, and Neonatal Adverse Outcomes: A Systematic Review and Meta‐Analysis</atitle><jtitle>Journal of midwifery & women's health</jtitle><addtitle>J Midwifery Womens Health</addtitle><date>2024-05</date><risdate>2024</risdate><volume>69</volume><issue>3</issue><spage>370</spage><epage>382</epage><pages>370-382</pages><issn>1526-9523</issn><issn>1542-2011</issn><eissn>1542-2011</eissn><notes>ObjectType-Article-1</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-2</notes><notes>ObjectType-Review-4</notes><notes>content type line 23</notes><notes>ObjectType-Undefined-3</notes><abstract>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.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>38750666</pmid><doi>10.1111/jmwh.13640</doi><tpages>13</tpages><orcidid>https://orcid.org/0000-0002-4470-0231</orcidid><orcidid>https://orcid.org/0000-0003-0230-8968</orcidid><orcidid>https://orcid.org/0000-0001-7918-2457</orcidid><orcidid>https://orcid.org/0000-0003-0044-4173</orcidid></addata></record> |
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| identifier | ISSN: 1526-9523 |
| ispartof | Journal of midwifery & women's health, 2024-05, Vol.69 (3), p.370-382 |
| issn | 1526-9523 1542-2011 1542-2011 |
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| source | Applied Social Sciences Index & Abstracts (ASSIA); Wiley |
| 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 |
| title | The Incidence of Intrahepatic Cholestasis of Pregnancy and its Maternal, Fetal, and Neonatal Adverse Outcomes: A Systematic Review and Meta‐Analysis |
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