{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T00:37:06Z","timestamp":1793752626446,"version":"4.6.1"},"reference-count":27,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2017,7,10]],"date-time":"2017-07-10T00:00:00Z","timestamp":1499644800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J of Obstet and Gynaecol"],"published-print":{"date-parts":[[2017,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>We aimed to determine the association between maternal total bile acid (TBA) levels and the risks of adverse perinatal outcomes in pregnant women with intrahepatic cholestasis of pregnancy (ICP) based on a meta\u2010analysis study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We searched PubMed for articles published from 2000 to 2015 with a focus on ICP and restriction to the English language. The main perinatal outcomes were preterm birth (PTB), meconium\u2010stained amniotic fluid (MSAF), asphyxia, or respiratory distress syndrome (RDS). Relative risk (RR) with 95% confidence intervals (CI) was the summary statistic. We used a random\u2010 or fixed\u2010effects model to calculate the pooled RR according to the heterogeneity test. Subgroup analyses were performed by region and study design.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Nine eligible related citations fulfilled the inclusion criteria and were included in this study. Compared with pregnant women with a serum TBA\u00a0&lt;\u00a040\u00a0\u03bcmol\/L, severe ICP (TBA\u00a0\u2265\u00a040\u00a0\u03bcmol\/L) was associated with a significantly increased risk of adverse fetal outcomes (pooled RR,\u00a01.96; 95%CI, 1.63\u20132.35), PTB (pooled RR,\u00a02.23; 95%CI, 1.51\u20133.29), MSAF (pooled RR, 2.27; 95%CI, 1.81\u20132.85), and asphyxia or RDS (pooled RR, 1.67; 95%CI, 1.18\u20132.36). Sensitivity analysis suggested that the study design difference may be a major source of heterogeneity. No publication bias was demonstrated by Begg's test (<jats:italic>P<\/jats:italic>\u00a0&gt;\u00a00.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This meta\u2010analysis indicates that maternal elevated bile acid levels are significantly associated with increased risks of overall adverse perinatal outcomes, PTB, MSAF, and asphyxia or RDS. Serum TBA levels seem to be a useful predictor for the risk of adverse perinatal outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jog.13399","type":"journal-article","created":{"date-parts":[[2017,7,10]],"date-time":"2017-07-10T07:46:59Z","timestamp":1499672819000},"page":"1411-1420","source":"Crossref","is-referenced-by-count":64,"title":["Bile acid levels and risk of adverse perinatal outcomes in intrahepatic cholestasis of pregnancy: A meta\u2010analysis"],"prefix":"10.1111","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3095-940X","authenticated-orcid":false,"given":"Donghua","family":"Cui","sequence":"first","affiliation":[{"name":"Department of Clinical Laboratory Shaoxing Women and Children Hospital  Shaoxing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongxing","family":"Zhong","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Shaoxing Women and Children Hospital  Shaoxing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Shaoxing Women and Children Hospital  Shaoxing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hechun","family":"Du","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Shaoxing Women and Children Hospital  Shaoxing 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