Abstract
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.
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Research funding: None declared.
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Author contributions: Conception or design: YM. Acquisition of data: ICM, ES. Analysis of data: ES, YM. Interpretation of data: MES. Drafting the work: MES, ICM. Revising it critically: ES,YM. Final approval of the version to be published: YM, ICM, ES, MES. Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. (YM, ES, ICM, MES accept). All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
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Competing interests: Authors state no conflict of interest.
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Informed consent: Informed consent was obtained from all individuals included in this study.
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Ethical approval: Approved by the Ethics Committee of Erciyes University (2019/231) and in accordance with the Declaration of Helsinki.
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Data availability: The data used to support the findings of this study are available on request from the corresponding author.
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