Impact of Covid-19 on the Prevalence of Intrahepatic Cholestasis of Pregnancy

Fida, Ruqia; Wahab, Shakeela; Naz, Asiya; Shah, Mustaqeem; Khan, Amir Zaman

doi:10.53350/pjmhs2023173543

Cited by 1 publication

(1 citation statement)

References 17 publications

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“…According to the Centers for Disease Control and Prevention (CDC), 40% of adults were avoiding medical care due to concerns related to COVID infection [24]. While there is one study showing contradictory results, comparing both conclusions is challenging due to different ethnic settings and timing [25]. In the latest study on the topic by Holden et al, the authors reported an increased incidence of COVID infection in women with ICP.…”

Section: Discussionmentioning

confidence: 99%

Intrahepatic Cholestasis of Pregnancy during COVID-19 Pandemic

Malarkiewicz,

Nowacka,

Januszaniec

et al. 2024

Medicina

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Background and Objectives: Intrahepatic cholestasis of pregnancy (ICP) stands as one of the most prevalent concerns in maternal–fetal medicine, presenting a significant risk to fetal health and often associated with liver dysfunction. Concurrently, the coronavirus-19 (COVID-19) infection can lead to hepatic cell injury through both direct and indirect pathways. Hypothetically, these two conditions may coincide, influencing each other. This study aimed to comparatively assess the incidence and severity of ICP before and during the COVID-19 pandemic. Methods: A retrospective cohort study was conducted, comparing the incidence and severity of ICP between January 2018 and February 2020 (pre-COVID-19 period) and March 2020 to March 2022 (COVID-19 period) across two hospitals, encompassing 7799 deliveries. The diagnosis of ICP was established using the ICD-10 code and defined as total bile acids (BA) levels ≥ 10 μmol/L. Statistical analysis included descriptive statistics, Chi-square and Mann–Whitney U tests, as well as multiple or logistic regression analysis. Results: A total of 226 cases of ICP were identified. The incidence of mild cholestasis (BA < 40 μmol/L) was lower during the pandemic compared to before (3% before versus 2%, p < 0.05), while the incidence of moderate and severe ICP remained unchanged (0.6% before vs. 0.4%, p = 0.2). Overall, the total incidence of ICP was lower during the pandemic (3.6% before versus 2.4%, p = 0.01). No significant differences were observed in severity (as defined by BA and liver function test levels), rates of caesarean section, or neonatal birth weights. Conclusions: During the COVID-19 pandemic, the total incidence of ICP appeared to be lower. However, this reduction was primarily observed in cases of mild ICP, potentially indicating challenges in detection or reduced access to medical services during this period. The incidence of moderate and severe ICP remained unchanged, suggesting that these forms of the condition were unaffected by the pandemic’s circumstances.

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Section: Discussionmentioning

confidence: 99%