American journal of reproductive immunology (New York, N.Y. : 1989) · 2025
Endothelial Activation and Stress Index as a Novel Prognostic Marker in Intrahepatic Cholestasis of Pregnancy: A Case-Control Study.
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Duygulu Bulan Dilara, Dayanan Ruken, Özkan Merve Ayas, Şeyhanlı Zeynep, Karabay Gülşan, Çağlar Ali Turhan
Аннотация
OBJECTIVE: This study aims to evaluate the clinical applicability and prognostic value of the endothelial activation and stress index (EASIX) in patients with intrahepatic cholestasis of pregnancy (ICP). By investigating the potential of the EASIX score to predict perinatal complications and the clinical course of ICP, we seek to contribute to the improved management and prognosis of ICP patients.
METHODS: This retrospective cohort study aimed to investigate the prognostic value of the EASIX in patients diagnosed with ICP at Ankara Etlik City Hospital between January 2023 and January 2025. A total of 121 ICP patients and 133 control patients were included. The EASIX score was calculated using lactate dehydrogenase, creatinine and thrombocyte levels. The relationship between EASIX and perinatal complications, including preterm birth and neonatal distress, was assessed.
RESULTS: The EASIX score was significantly higher in the ICP group compared to controls (p < 0.001), with severe ICP showing the highest EASIX scores (p = 0.019). Cut-off analysis indicated that an EASIX score > 0.64 had a sensitivity of 75% and specificity of 64% for severity prediction (AUC = 0.767, p < 0.001), while a score > 0.69 had a sensitivity of 62% and specificity of 61% for predicting composite adverse perinatal outcomes (AUC = 0.711, p < 0.001).
CONCLUSION: This study demonstrates that the EASIX score may serve as an important prognostic tool in predicting disease severity and neonatal outcomes in ICP. Given the limited availability of bile acid measurements in some clinics, the EASIX score provides a practical and accessible alternative for clinical use. This study evaluates the prognostic value of the endothelial activation and stress index (EASIX) in intrahepatic cholestasis of pregnancy, highlighting its potential to predict disease severity and neonatal outcomes, offering a practical tool for clinical use.
METHODS: This retrospective cohort study aimed to investigate the prognostic value of the EASIX in patients diagnosed with ICP at Ankara Etlik City Hospital between January 2023 and January 2025. A total of 121 ICP patients and 133 control patients were included. The EASIX score was calculated using lactate dehydrogenase, creatinine and thrombocyte levels. The relationship between EASIX and perinatal complications, including preterm birth and neonatal distress, was assessed.
RESULTS: The EASIX score was significantly higher in the ICP group compared to controls (p < 0.001), with severe ICP showing the highest EASIX scores (p = 0.019). Cut-off analysis indicated that an EASIX score > 0.64 had a sensitivity of 75% and specificity of 64% for severity prediction (AUC = 0.767, p < 0.001), while a score > 0.69 had a sensitivity of 62% and specificity of 61% for predicting composite adverse perinatal outcomes (AUC = 0.711, p < 0.001).
CONCLUSION: This study demonstrates that the EASIX score may serve as an important prognostic tool in predicting disease severity and neonatal outcomes in ICP. Given the limited availability of bile acid measurements in some clinics, the EASIX score provides a practical and accessible alternative for clinical use. This study evaluates the prognostic value of the endothelial activation and stress index (EASIX) in intrahepatic cholestasis of pregnancy, highlighting its potential to predict disease severity and neonatal outcomes, offering a practical tool for clinical use.