{"doi":"10.1002/pmf2.70073","title":"Earlier diagnosis of intrahepatic cholestasis of pregnancy and adverse pregnancy outcomes","abstract":"INTRODUCTION: We aimed to determine whether pregnancies complicated by early diagnosis of cholestasis were associated with adverse maternal or neonatal outcomes. METHODS: This is a retrospective cohort study of singleton, non-anomalous live gestations complicated by cholestasis from 2005-2019. We compared rates of adverse outcomes in pregnancies complicated by early (<32-week gestational age) versus late (≥ 32-week gestational age) diagnosis of cholestasis. Our primary outcome of interest was rates of spontaneous preterm birth. Secondary outcomes included rates of iatrogenic preterm birth, meconium-stained amniotic fluid, cesarean delivery for non-reassuring fetal heart tracing, and neonatal intensive care unit admission. RESULTS: Of the 1247 pregnancies complicated by cholestasis, 241 (19.3%) had early diagnosis and 1006 (80.7%) had late diagnosis. After adjusting for confounders including peak total bile acid levels, earlier diagnosis of cholestasis remained associated with spontaneous preterm birth (OR 1.81; 95% CI 1.11-2.95), iatrogenic preterm birth, (OR 1.59; 95% CI 1.12-2.67), and NICU admission (OR 1.43; 95% CI 1.04-1.95). A sub-analysis to compare outcomes with severe cholestasis (peak total bile acids ≥ 40 μmol/L) showed early diagnosis of severe cholestasis was also associated with spontaneous preterm labor (OR 2.41; 95% CI 1.34-4.34), iatrogenic preterm birth, (OR 1.67; 95% CI 1.05-2.67), and NICU admission (OR 1.66; 95% CI 1.06-2.61). CONCLUSION: Findings suggests that earlier diagnosis of cholestasis is associated with adverse outcomes and that this is not entirely driven by peak total bile acid levels.","journal":"Pregnancy","year":2025,"id":571656,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9583,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":873418,"name":"Dana R. Canfield","orcid":null,"position":1,"is_corresponding":false},{"id":1313768,"name":"Lauren Ferrara","orcid":null,"position":2,"is_corresponding":false},{"id":1214473,"name":"Chelsea A. DeBolt","orcid":"0000-0002-9532-4109","position":3,"is_corresponding":false},{"id":1313396,"name":"Minhazur R. Sarker","orcid":"0000-0002-2677-3023","position":0,"is_corresponding":true}],"reference_count":28,"raw_metadata":null,"created_at":"2026-07-19T02:57:19.669553Z","pmid":"40959761","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}