Severe Intrahepatic Cholestasis Pregnancy Is Associated With Maternal Endothelial Dysfunction: A Case-Control Study

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Vascular Biology

Background:

• Intrahepatic cholestasis of pregnancy (ICP) is a liver disorder during pregnancy.
• Endocan is a marker for vascular pathologies, inflammation, and endothelial dysfunction.
• Elevated bile acids are characteristic of ICP.

Purpose of the Study:

• To investigate maternal serum endocan levels in pregnancies with ICP.
• To correlate endocan levels with ICP severity and biochemical markers.

Main Methods:

• A case-control study involving 30 mild ICP, 30 severe ICP, and 30 healthy pregnant women.
• ICP diagnosis based on pruritus, elevated total bile acids (TBA), and/or aminotransferases.
• Severe ICP defined as TBA > 40 μmol/L.
• Maternal serum endocan levels were measured before treatment.

Main Results:

• Maternal serum endocan levels were significantly higher in severe ICP (24.3 ± 4.8 ng/mL) compared to mild ICP (12.5 ± 2.8 ng/mL) and controls (10.9 ± 2.6 ng/mL).
• Severe ICP was associated with higher rates of delivery induction, NICU admission, and elevated TBA and aminotransferases.
• No significant difference in gestational age at blood sampling across groups.

Conclusions:

• Maternal serum endocan levels are elevated in severe ICP.
• Increased endocan may indicate endothelial dysfunction associated with elevated bile acids in severe ICP.
• Endocan could serve as a potential biomarker for ICP severity.