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Analyzing the association between ferritin levels and ICP using machine learning algorithms: a retrospective

Na Wei1, Shuang Guo1, Xiaoya Liu1

  • 1Department of Obstetrics, Guizhou Provincial People's Hospital, Guiyang, Guizhou, China.

Frontiers in Medicine
|May 4, 2026
PubMed
Summary
This summary is machine-generated.

Elevated serum ferritin levels during pregnancy are linked to an increased risk of intrahepatic cholestasis of pregnancy (ICP). This study highlights iron metabolism as a potential factor in ICP development.

Keywords:
ferritinintrahepatic cholestasis of pregnancylogistic regressionrandom forestrestricted cubic spline

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Area of Science:

  • Obstetrics and Gynecology
  • Maternal-Fetal Medicine
  • Clinical Biochemistry

Background:

  • Intrahepatic cholestasis of pregnancy (ICP) is a liver disorder during pregnancy affecting bile acid homeostasis.
  • Emerging evidence suggests a role for iron metabolism dysregulation in ICP pathophysiology.
  • Specific alterations in iron metabolism in ICP patients are not well understood.

Purpose of the Study:

  • To investigate the association between serum ferritin levels and the risk of intrahepatic cholestasis of pregnancy (ICP).
  • To explore the relationship between iron metabolism markers and ICP in pregnant individuals.

Main Methods:

  • Retrospective study comparing serum ferritin in normal pregnancies versus ICP cases.
  • Utilized Propensity Score Matching (PSM), trend analysis, restricted cubic spline (RCS) analysis, and random forest algorithm.
  • Analyzed data from Guizhou Provincial People's Hospital (January 2023 - March 2025).

Main Results:

  • ICP patients exhibited higher serum ferritin levels compared to healthy controls throughout gestation.
  • Elevated third-trimester ferritin levels were significantly associated with increased ICP risk (AOR = 1.005).
  • Nonlinear relationships (U-shaped in 2nd trimester, J-shaped in 3rd) observed between ferritin and ICP risk; ferritin identified as a key predictor.

Conclusions:

  • Increased serum ferritin levels during pregnancy may be associated with a higher risk of developing ICP.
  • The precise mechanisms linking ferritin to ICP require further investigation.
  • Large-scale prospective multicenter cohort studies are recommended to clarify these mechanisms.