{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T17:25:50Z","timestamp":1789838750443,"version":"4.0.1"},"reference-count":30,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T00:00:00Z","timestamp":1769126400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T00:00:00Z","timestamp":1769126400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate the diagnostic utility of three non\u2010invasive hepatic fibrosis indices\u2014aminotransferase\u2010to\u2010platelet ratio index (APRI), Fibrosis\u20104 (FIB\u20104), and FIB\u20105\u2014in pregnancies complicated by intrahepatic cholestasis of pregnancy (ICP), and exploratory analysis of neonatal outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective case\u2013control study included 217 pregnant women who delivered at G\u00f6ztepe Prof. Dr. S\u00fcleyman Yal\u00e7\u0131n City Hospital, a tertiary care center affiliated with Istanbul Medeniyet University, between September 2018 and February 2024. The study population was divided into two groups: 105 women diagnosed with ICP and 112 pregnant women without ICP who served as controls. The diagnosis of ICP was based on clinical pruritus, elevated serum bile acid levels (&gt;10\u2009\u03bcmol\/L), and abnormal liver function tests. Women with pre\u2010eclampsia, HELLP (hemolysis, elevated liver enzymes, and low platelets) syndrome, coagulopathy, hepatitis, multiple pregnancies, or other hepatic conditions were excluded. Laboratory parameters including aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), albumin, and platelet counts were used to calculate APRI, FIB\u20104, and FIB\u20105 scores. Statistical analyses included Mann\u2013Whitney\n                      <jats:italic>U<\/jats:italic>\n                      \u2010tests for group comparisons and receiver operating characteristics (ROC) curve analyses to determine the diagnostic performance of each score.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      APRI and FIB\u20105 scores were significantly higher in the ICP group compared with controls, whereas FIB\u20104 showed a smaller between\u2010group difference (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001 for APRI and FIB\u20105;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.022 for FIB\u20104). ROC analysis demonstrated good diagnostic performance for APRI (area nder the curve [AUC]\u2009=\u20090.902; cut\u2010off\u2009=\u20090.39; sensitivity\u2009=\u200982%; specificity\u2009=\u200989%) and moderate performance for FIB\u20105 (AUC\u2009=\u20090.718; cut\u2010off\u2009=\u2009\u22121.84; sensitivity\u2009=\u200967%; specificity\u2009=\u200970%). FIB\u20104 showed lower diagnostic value (AUC\u2009=\u20090.590). Elevated scores were also associated with adverse neonatal outcomes, increased rates of preterm birth, and greater need for neonatal intensive care.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>APRI, FIB\u20104, and FIB\u20105 are elevated in pregnancies affected by ICP and may serve as supportive, non\u2010invasive markers reflecting hepatocellular stress and hepatic involvement. Among these indices, APRI showed the best diagnostic performance, FIB\u20105 demonstrated moderate discriminative ability, and FIB\u20104 had limited diagnostic utility. These indices may provide clinicians with additional information when evaluating hepatic dysfunction and may be associated with neonatal outcomes, although they are not validated prognostic tools. Prospective studies are warranted to further validate their clinical utility.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ijgo.70807","type":"journal-article","created":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T09:56:04Z","timestamp":1769162164000},"page":"253-263","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Diagnostic utility of\n                    <scp>APRI<\/scp>\n                    ,\n                    <scp>FIB<\/scp>\n                    \u20104, and\n                    <scp>FIB<\/scp>\n                    \u20105 in intrahepatic cholestasis of pregnancy: A retrospective case\u2013control study"],"prefix":"10.1002","volume":"174","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6147-8102","authenticated-orcid":false,"given":"Sevil","family":"Cicek","sequence":"first","affiliation":[{"name":"Department of Perinatology Goztepe Professor Dr. S\u00fcleyman Yal\u00e7\u0131n Training and Research Hospital  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5622-3161","authenticated-orcid":false,"given":"Bilge","family":"Kapudere","sequence":"additional","affiliation":[{"name":"Department of Perinatology Goztepe Professor Dr. S\u00fcleyman Yal\u00e7\u0131n Training and Research Hospital  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9639-7484","authenticated-orcid":false,"given":"Yasemin Beyza Kaya","family":"Parspanc\u0131","sequence":"additional","affiliation":[{"name":"Department of Perinatology Goztepe Professor Dr. S\u00fcleyman Yal\u00e7\u0131n Training and Research Hospital  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6951-4761","authenticated-orcid":false,"given":"Zehra","family":"Tavukcuoglu","sequence":"additional","affiliation":[{"name":"Department of Perinatology Goztepe Professor Dr. S\u00fcleyman Yal\u00e7\u0131n Training and Research Hospital  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0869-4660","authenticated-orcid":false,"given":"Omer Gokhan","family":"Eyisoy","sequence":"additional","affiliation":[{"name":"Department of Perinatology, Clinic of Obstetrics and Gynecology Yozgat City Hospital  Yozgat Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5261-1792","authenticated-orcid":false,"given":"Reyhan","family":"Ayaz","sequence":"additional","affiliation":[{"name":"Department of Perinatology Goztepe Professor Dr. S\u00fcleyman Yal\u00e7\u0131n Training and Research Hospital  Istanbul 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