Characteristics associated with alterations in pruritus severity across gestation in intrahepatic cholestasis of pregnancy: a longitudinal cohort study.

BACKGROUND

Pruritus is a common symptom of intrahepatic cholestasis of pregnancy (ICP), yet its relationship with hypercholanaemia and progression across gestation remains unclear.

METHODS

139 participants (1997-2020) recruited from nine UK hospitals and ICP Support. Maternal characteristics and serial serum measurements were collected. Pruritus severity was categorized into five levels. Multiple logistic regression was used to evaluate factors associated with pruritus deterioration.

RESULTS

Among 139 women, 53 % (61/115) experienced pruritus deterioration. ALT and bilirubin were not significantly associated with severity progression. However, bile acid concentration (OR 2.36, 95 % CI 1.22-4.56) and maternal BMI (OR 2.40, 95 % CI 1.20-4.81) were independent risk factors. A higher risk of pruritus severity deterioration was found in those with peak bile acid concentrations ≥ 100 µmol/L (OR 7.45, 95 %CI 1.43-38.86, p = 0.02).

CONCLUSION

Higher peak bile acid concentrations and maternal BMI are associated with worsening pruritus severity in ICP.