Revista da Associacao Medica Brasileira (1992) · 2025
Maternal soluble urokinase plasminogen activator receptor levels in intrahepatic cholestasis of pregnancy: a predictor of neonatal intensive care unit admission.
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Aktaş Betül Akgün, Agaoglu Zahid, Peker Betül Nur, Başaran Ezgi, Orhan Nazlı, Özdal Burcu Bozkurt, Şahin Dilek
Аннотация
OBJECTIVE: The aim of this study was to compare maternal plasma soluble urokinase plasminogen activator receptor levels in pregnant women diagnosed with intrahepatic cholestasis of pregnancy with those in healthy pregnant women and to evaluate its predictive value for neonatal intensive care unit admission.
METHODS: This study is a prospective case-control study and was conducted with a total of 80 participants, including 38 pregnant women with intrahepatic cholestasis of pregnancy and 42 healthy pregnant women between 28 and 37 weeks of gestation. To evaluate the predictive value of maternal suPAR and bile acid levels for neonatal intensive care unit admission, receiver operating characteristic curves were generated.
RESULTS: Maternal serum alanine aminotransferase, aspartate aminotransferase, and direct bilirubin levels were statistically significantly higher in the intrahepatic cholestasis of pregnancy group compared to the control. In the intrahepatic cholestasis of pregnancy group, the plasma soluble urokinase plasminogen activator receptor level was 0.42±0.6 ng/mL, whereas in the control group it was 0.18±0.1 ng/mL (p=0.038). The intrahepatic cholestasis of pregnancy group delivered at an earlier gestational age and with lower birth weight, and the need for neonatal intensive care unit admission was statistically significantly higher. In both the severe and mild intrahepatic cholestasis of pregnancy groups, spontaneous preterm birth was more frequent than iatrogenic preterm birth. In the severe intrahepatic cholestasis of pregnancy group, there was one neonatal death and one meconium-stained birth. The discriminatory power of soluble urokinase plasminogen activator receptor levels in predicting neonatal intensive care unit need was found to be statistically significant (area under the curve: 0.757; 95%CI 0.552-0.962; p=0.022).
CONCLUSION: High maternal plasma soluble urokinase plasminogen activator receptor levels may predict adverse pregnancy outcomes.
METHODS: This study is a prospective case-control study and was conducted with a total of 80 participants, including 38 pregnant women with intrahepatic cholestasis of pregnancy and 42 healthy pregnant women between 28 and 37 weeks of gestation. To evaluate the predictive value of maternal suPAR and bile acid levels for neonatal intensive care unit admission, receiver operating characteristic curves were generated.
RESULTS: Maternal serum alanine aminotransferase, aspartate aminotransferase, and direct bilirubin levels were statistically significantly higher in the intrahepatic cholestasis of pregnancy group compared to the control. In the intrahepatic cholestasis of pregnancy group, the plasma soluble urokinase plasminogen activator receptor level was 0.42±0.6 ng/mL, whereas in the control group it was 0.18±0.1 ng/mL (p=0.038). The intrahepatic cholestasis of pregnancy group delivered at an earlier gestational age and with lower birth weight, and the need for neonatal intensive care unit admission was statistically significantly higher. In both the severe and mild intrahepatic cholestasis of pregnancy groups, spontaneous preterm birth was more frequent than iatrogenic preterm birth. In the severe intrahepatic cholestasis of pregnancy group, there was one neonatal death and one meconium-stained birth. The discriminatory power of soluble urokinase plasminogen activator receptor levels in predicting neonatal intensive care unit need was found to be statistically significant (area under the curve: 0.757; 95%CI 0.552-0.962; p=0.022).
CONCLUSION: High maternal plasma soluble urokinase plasminogen activator receptor levels may predict adverse pregnancy outcomes.
Предметные рубрики MeSH
HumansFemalePregnancyCholestasis, IntrahepaticReceptors, Urokinase Plasminogen ActivatorIntensive Care Units, NeonatalCase-Control StudiesProspective StudiesPregnancy ComplicationsAdultBiomarkersPredictive Value of TestsInfant, NewbornGestational AgeROC CurveAspartate AminotransferasesYoung AdultAlanine TransaminaseReference Values