Intrahepatic cholestasis of pregnancy has no effect on maternal serum second trimester alpha-fetoprotein and hCG

To investigate the association between intrahepatic cholestasis and Down's syndrome screening analytes (alpha-fetoprotein [AFP] and hCG) during the second trimester.

Measurements of maternal serum AFP and hCG concentrations were retrospectively analyzed in relation to intrahepatic cholestasis in a cohort of 33 consecutive singleton pregnancies affected by cholestasis from January 1995 through December 1997 at the University Hospital of Kuopio, and then compared with those in healthy singleton control pregnancies (n=5680) from the same clinic over the same period of time.

Geometric means of maternal serum AFP and hCG concentrations in pregnancies affected by cholestasis were 1.12 and 0.98 multiples of the median [MoM], respectively. Mean maternal age was significantly higher in the subjects than in controls (30.6 years compared with 28.8 years). In relation to Down's syndrome risk assessment, the pattern of the two markers together with maternal age indicated high risk as often in the study subjects as in the controls.

Median serum AFP and hCG concentrations in pregnancies complicated by intrahepatic cholestasis were not significantly different from those in unaffected pregnancies. There is no need to take the hepatic disorder into account in maternal serum screening.