Objectives Considering the effects of bile-acid levels on fetal lungs and pulmonary surfactants, we hypothesized that in the presence of intrahepatic pregnancy cholestasis (ICP), poor neonatal respiratory problems are observed in relation to the severity of the disease. Delivery timing with the presence of ICP is scheduled during late-preterm and early term gestational weeks. The aim of this study was to assess ICP and disease severity effects on transient tachypnea of the newborn (TTN) in uncomplicated fetuses. Methods This study comprised 1,097 singleton pregnant women who were separated into three groups—control, mild ICP, and severe ICP. The pregnant women diagnosed with ICP between January 2010 and September 2020 was investigated using the hospital’s database. For the control group, healthy pregnant women who met the same exclusion criteria and were similar in terms of maternal age, gestational age at delivery, and mode of delivery were analyzed. Results The TTN rate was 14.5% in the severe ICP group, 6.5% in the mild ICP group, and 6.2% in the control group. The TTN rate in the severe ICP group was significantly higher than that in the other groups (p<0.001). Similarly, the rate of admission to the neonatal intensive care unit was significantly higher in the severe ICP group than in the other groups (p<0.001). According to Pearson correlation analyses, maternal serum bile–acid levels were positively correlated with TTN (r=0.082; p=0.002). Conclusions Severe ICP, but not mild ICP, and serum bile–acid levels were positively correlated with increased TTN risk and reduced pulmonary surfactant levels.

中文翻译：

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妊娠期肝内胆汁淤积的评估及疾病严重程度对单纯性胎儿新生儿短暂性呼吸急促的影响

目的 考虑到胆汁酸水平对胎儿肺和肺表面活性物质的影响，我们假设在存在妊娠肝内胆汁淤积症 (ICP) 的情况下，观察到的新生儿呼吸问题与疾病的严重程度有关。存在 ICP 的分娩时间安排在早产晚期和早期妊娠周。本研究的目的是评估 ICP 和疾病严重程度对新生儿短暂性呼吸急促 (TTN) 的影响在简单的胎儿中. 方法 本研究包括 1097 名单胎孕妇，她们被分为三组——对照组、轻度 ICP 组和重度 ICP。使用医院的数据库对 2010 年 1 月至 2020 年 9 月期间诊断为 ICP 的孕妇进行了调查。对于对照组，分析符合相同排除标准并且在孕产妇年龄、分娩胎龄和分娩方式方面相似的健康孕妇。结果重度ICP组TTN率为14.5%，轻度ICP组为6.5%，对照组为6.2%。严重ICP组的TTN率显着高于其他组（p<0.001）。同样，重度 ICP 组新生儿重症监护病房的入院率显着高于其他组（p<0.001）。根据 Pearson 相关分析，母体血清胆汁酸水平与 TTN 呈正相关（r=0.082；p=0.002）。结论 重度 ICP 而非轻度 ICP 和血清胆汁酸水平与 TTN 风险增加和肺表面活性物质水平降低呈正相关。