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Jaundice of pregnancy (intrahepatic cholestasis ) is associated with low vitamin D – July 2018

Low serum vitamin D level is associated with intrahepatic cholestasis of pregnancy.

J Obstet Gynaecol Res. 2018 Jul 6. doi: 10.1111/jog.13693. [Epub ahead of print]
Gençosmanoğlu Türkmen G1, Vural Yilmaz Z1, Dağlar K1, Kara Ö1, Sanhal CY1, Yücel A1, Uygur D1.
Zekai Tahir Burak Women's Health Care, Training and Research Hospital, Ankara, Turkey.


Summary of Vitamin D levels
With ICP = 8 ng, wihout ICP = 11 ng
Mild ICP = 10 ng, Severe ICP = 7

Healthy pregnancies need lots of vitamin D has the following summary

0. Chance of not conceiving3.4 times Observe
1. Miscarriage 2.5 times Observe
2. Pre-eclampsia 3.6 timesRCT
3. Gestational Diabetes 3 times RCT
4. Good 2nd trimester sleep quality 3.5 times Observe
5. Premature birth 2 times RCT
6. C-section - unplanned 1.6 timesObserve
     Stillbirth - OMEGA-3 4 timesRCT - Omega-3
7. Depression AFTER pregnancy 1.4 times RCT
8. Small for Gestational Age 1.6 times meta-analysis
9. Infant height, weight, head size
     within normal limits
10. Childhood Wheezing 1.3 times RCT
11. Additional child is Autistic 4 times Intervention
12.Young adult Multiple Sclerosis 1.9 timesObserve
13. Preeclampsia in young adult 3.5 timesRCT
14. Good motor skills @ age 31.4 times Observe
15. Childhood Mite allergy 5 times RCT
16. Childhood Respiratory Tract visits 2.5 times RCT

RCT = Randomized Controlled Trial
From the web

  • "Intrahepatic cholestasis of pregnancy (ICP) is a reversible type of hormonally influenced cholestasis. It frequently develops in late pregnancy in individuals who are genetically predisposed. It is the most common pregnancy-related liver disorder."
  • "ICP is associated with poor obstetric and fetal outcomes such as preterm labor (19 to 60%), meconium passage (30%) and fetal death (1 to 7%)."
  • "The overall prevalence of ICP in this population was 5.6%" (Latina population in Low Angeles) July 2006
  • BMC Best Practice - cholestasis of pregnancy Extensive
    "Definition: Intrahepatic cholestasis of pregnancy (ICP) is a pruritic condition during pregnancy caused by impaired bile flow allowing bile salts to be deposited in the skin and the placenta. The cause is a combination of hormonal, genetic, and environmental factors. ICP may predispose mothers to vitamin K deficiency and the fetus to adverse pregnancy outcomes that may include prematurity, intrauterine fetal demise, and respiratory distress syndrome."
  • It appears that ICP reduces the absorption of fat soluable Vitamins such as K and D

Intrahepatic cholestasis of pregnancy (ICP) is a unique hepatic disorder of pregnancy and is related to adverse maternal and perinatal outcomes. The pathogenesis of the disease is not clear and appears to be multifactorial. There is increasing evidence that vitamin D (Vit D) plays a role in hepatobiliary homeostasis and in various liver diseases. We aimed to investigate the association between serum Vit D level and ICP.

A total of 40 pregnant women with ICP and 40 healthy pregnant women were included in this controlled cross-sectional study. Their demographic characteristics, including age, body mass index (BMI), gestational week, gravidity and parity, and laboratory parameters, including 25(OH) Vit D3 levels, liver function tests, fasting and postprandial bile acid concentrations, were recorded. Gestational age at delivery, birth weight (BW), neonatal intensive care unit (NICU) admission, meconium staining of amniotic fluid and appearance pulse grimace activity respiration (APGAR) score at 5 min were obtained from medical records for assessment of perinatal outcomes.

There was no significant difference between groups in terms of demographic characteristics. The mean serum 25(OH) Vit D3 level was significantly lower in pregnant women with ICP compared to control pregnant women (8.6 ± 4.9, 11.3 ± 6.1; P =0.033), and it was significantly lower in severe disease than mild disease (6.9 ± 2.1, 10.3 ± 6.2, respectively; P =0.029). We also found that lower serum 25(OH) Vit D3 levels were significantly and inversely correlated with fasting and postprandial bile acid levels. However, in subgroup analyses in ICP pregnant women, there was no difference in mean 25(OH) Vit D3 levels for women with or without perinatal complications.

Our study suggests that low levels of 25(OH) Vit D3 were associated with ICP disease and its severity. However, further larger studies are needed to evaluate the effect of Vit D in the pathogenesis and outcome of the disease.

Created by admin. Last Modification: Saturday July 7, 2018 11:39:15 GMT-0000 by admin. (Version 3)
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