Abstract
Background ICP pregnant women have a unique profile of serum bile acid metabolis, early and accurate identification of ICP patients is beneficial to early appropriate treatment and improvement of pregnancy outcomes. In this study, ultra-high performance liquid chromatography-mass spectrometry/mass spectrometry (UPLC-MS/MS) was used to analyze the 15 types of serum bile acid profiles of ICP in third trimester, patients with cholelithiasis, and patients with hepatitis B virus. The ICP diagnostic model established by partial least squares-discriminant analysis (PLS-DA) was used to screen the differential bile acids for clinical subtypes of ICP. 144 cases of ICP patients were involved in this study, and were divided into four subgroups according to serum levels of TBA, DBIL, and ALT. Results ①The differential serum bile acid profiles of ICP group and normal pregnant women were DCA, TDCCA, TCA, GDCA and GLCA.②The differential serum bile acid profiles of the ICP1 group (ICP with jaundice) and normal pregnant women were TCDCA, TCA, GCA, GCDCA, TUDCA and GUDCA.③The differential serum bile acid profiles of the ICP3 group (hyperbiliary acidemia of pregnancy) and normal pregnant group was GUDCA, LCA, GLCA, UDCA, TUDCA, CDCA, and TLCA (P <0.05).④The differential serum bile acid profiles of ICP4 group (idiopathic aminotransferase abnormality during pregnancy) and normal pregnant group was UDCA, GUDCA, TUDCA, GCA and GLCA (P <0.05).⑤The occurrence of meconium-stained amniotic fluid, premature delivery and cesarean section in ICP1 group was significantly higher than normal group,ICP2 group,ICP3 group,and ICP4 group (P <0.05); The occurrence of meconium-stained amniotic fluid, premature delivery and cesarean section in ICP2 group, ICP3 group,and ICP4 group was significantly higher than normal group (P <0.05), but no difference was found among ICP2 group, ICP3 group,and ICP4 group (P> 0.05). Conclusion: Maternal serum bile acid profiles are useful to differentiate the four subtypes of ICP. ICP with jaundice could be an important predictor of adverse pregnancy outcomes of ICP.
Chenodeoxycholic Acid Administration Monitored by Serum Bile Acid Profiles: A Dose-Response Study