{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T07:41:52Z","timestamp":1792827712476,"version":"4.5.0"},"reference-count":18,"publisher":"American Academy of Pediatrics (AAP)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2006,5,1]]},"abstract":"<jats:p>OBJECTIVES. We sought to verify the association between maternal intrahepatic cholestasis of pregnancy (ICP) and neonatal respiratory distress syndrome (RDS) and to determine how bile acids levels alter the risk of developing neonatal RDS.<\/jats:p>\n               <jats:p>METHODS. We extracted data from our divisional database about all of the newborns born during the years 2000\u20132004. We compared 77 neonates born from pregnancies complicated by ICP with 427 neonates in the same range of gestational age born from noncomplicated pregnancies. We studied maternal bile acids levels immediately before delivery in mothers with ICP and measured bile acid levels during the first 24 hours of life in their newborns.<\/jats:p>\n               <jats:p>RESULTS. The incidence of RDS in newborns from cholestatic pregnancies was twice that the reference population (28.6% vs 14%). The multivariate analysis showed that the risk of RDS in these newborns was \u223c2.5 times higher than in control infants. Within the ICP group, maternal and neonatal bile acid levels of infants affected by RDS were not significantly higher than those of healthy infants. The multivariate analysis showed that a low gestational age was the most important risk factor, but the probability of respiratory distress syndrome also increased by 2\u2030 for every additional micromole of the interaction term \u201cneonatal by maternal bile acids level.\u201d<\/jats:p>\n               <jats:p>CONCLUSIONS. Maternal ICP is significantly associated with the occurrence of RDS in the newborn. We hypothesize that bile acids can produce surfactant depletion in the alveoli reverting the reaction of phospholipase A2. This hypothesis could potentially be confirmed by bronchoalveolar lavage study.<\/jats:p>","DOI":"10.1542\/peds.2005-1801","type":"journal-article","created":{"date-parts":[[2006,5,1]],"date-time":"2006-05-01T17:22:05Z","timestamp":1146504125000},"page":"1669-1672","source":"Crossref","is-referenced-by-count":89,"title":["Intrahepatic Cholestasis of Pregnancy and Neonatal Respiratory Distress Syndrome"],"prefix":"10.1542","volume":"117","author":[{"given":"Enrico","family":"Zecca","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Division of Neonatology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniele","family":"De Luca","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Neonatology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Marras","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Neonatology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Caruso","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tommaso","family":"Bernardini","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Costantino","family":"Romagnoli","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Neonatology"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2006,5,1]]},"reference":[{"key":"2021120823255098000_R1","doi-asserted-by":"crossref","unstructured":"Glantz A, Marschall HU, Mattsson LA. Intrahepatic cholestasis of pregnancy: relationship between bile acids levels and fetal complication rates. Hepatology.\u20082004;40:467\u2013474","DOI":"10.1002\/hep.20336"},{"key":"2021120823255098000_R2","doi-asserted-by":"crossref","unstructured":"Milkiewicz P, Elias E, Williamson C, Weaver J. Obstetric cholestasis. BMJ.\u20082002;324:123\u2013124","DOI":"10.1136\/bmj.324.7330.123"},{"key":"2021120823255098000_R3","doi-asserted-by":"crossref","unstructured":"Laatikainen TJ. Fetal bile acid levels in pregnancies complicated by maternal intrahepatic cholestasis. Am J Obstet Gynecol.\u20081975;122:852\u2013856","DOI":"10.1016\/0002-9378(75)90727-9"},{"key":"2021120823255098000_R4","doi-asserted-by":"crossref","unstructured":"Roncaglia N, Arreghini A, Locatelli A, Bellini P, Andreotti C, Ghidini A. Obstetric cholestasis: outcome with active management. Eur J Obstet Gynecol Reprod Biol.\u20082002;100:167\u2013170","DOI":"10.1016\/S0301-2115(01)00463-8"},{"key":"2021120823255098000_R5","doi-asserted-by":"crossref","unstructured":"Zecca E, Costa S, Lauriola V, Vento G, Papacci P, Romagnoli C. Bile acid pneumonia: a \u201cnew\u201d form of neonatal respiratory distress syndrome?Pediatrics.\u20082004;114:269\u2013272","DOI":"10.1542\/peds.114.1.269"},{"key":"2021120823255098000_R6","doi-asserted-by":"crossref","unstructured":"Berg B, Helm G, Petersohn L, Tryding N. Cholestasis of pregnancy: clinical and laboratory studies. Acta Obstet Gynecol Scand.\u20081986;65:107\u2013113","DOI":"10.3109\/00016348609158363"},{"key":"2021120823255098000_R7","doi-asserted-by":"crossref","unstructured":"Roncaglia N, Locatelli A, Arreghini A, et al. A randomised controlled trial of ursodeoxycholic acid and S-adenosyl-L-methionine in the treatment of gestational cholestasis. BJOG.\u20082004;111:17\u201321","DOI":"10.1046\/j.1471-0528.2003.00029.x"},{"key":"2021120823255098000_R8","doi-asserted-by":"crossref","unstructured":"Lammert F, Marshall HU, Matern S. Intrahepatic cholestasis of pregnancy. Curr Treat Options Gastroenterol.\u20082003;6:123\u2013132","DOI":"10.1007\/s11938-003-0013-x"},{"key":"2021120823255098000_R9","doi-asserted-by":"crossref","unstructured":"Lammert F, Marshall HU, Glantz A, Matern S. Intrahepatic cholestasis of pregnancy: molecular pathogenesis, diagnosis and management. J Hepatol.\u20082000;33:1012\u20131021","DOI":"10.1016\/S0168-8278(00)80139-7"},{"key":"2021120823255098000_R10","unstructured":"Walti H, Couchard M, Relier JP. Neonatal diagnosis of respiratory distress syndrome. Eur Respir J.\u20081989;2(suppl 2):22s\u201327s"},{"key":"2021120823255098000_R11","unstructured":"Heikkinen J, Maentausta O, Tuimala R, Ylostalo P, Janne O. Amniotic fluid bile acids in normal and pathologic pregnancy. Obstet Gynecol.\u20081980;56:60\u201364"},{"key":"2021120823255098000_R12","doi-asserted-by":"crossref","unstructured":"Howard PJ, Murphy GM. Bile acid stress in the mother and baby unit. Eur J Gastroenterol Hepatol.\u20082003;15:317\u2013321","DOI":"10.1097\/00042737-200303000-00016"},{"key":"2021120823255098000_R13","doi-asserted-by":"crossref","unstructured":"Colombo C, Roda A, Roda E, et al. Correlation between fetal and maternal serum bile acid concentrations. Pediatr Res.\u20081985;19:227\u2013231","DOI":"10.1203\/00006450-198502000-00018"},{"key":"2021120823255098000_R14","doi-asserted-by":"crossref","unstructured":"Hills BA, Chen Y, Masters IB, Hills YC. Raised bile acid concentrations in SIDS lungs at necropsy. Arch Dis Child.\u20081997;77:120\u2013123","DOI":"10.1136\/adc.77.2.120"},{"key":"2021120823255098000_R15","doi-asserted-by":"crossref","unstructured":"Ihse I, Arnesjo B. The phospholipase activity of human small intestinal contents. Acta Chem Scand.\u20081973;27:2749\u20132756","DOI":"10.3891\/acta.chem.scand.27-2749"},{"key":"2021120823255098000_R16","doi-asserted-by":"crossref","unstructured":"Kaneko T, Sato T, Katsuva H, Mivauchi Y. Surfactant therapy for pulmonary edema due to intratracheally injected bile acid. Crit Care Med.\u20081990;18:77\u201383","DOI":"10.1097\/00003246-199001000-00017"},{"key":"2021120823255098000_R17","doi-asserted-by":"crossref","unstructured":"Porembka DT, Kier A, Sehlhorst S, Boyce S, Orlowski JP, Davis K. The pathophysiological changes following bile aspiration in a porcine lung model. Chest.\u20081993;104:919\u2013924","DOI":"10.1378\/chest.104.3.919"},{"key":"2021120823255098000_R18","doi-asserted-by":"crossref","unstructured":"Egerman RS, Riely CA. Predicting fetal outcome in intrahepatic cholestasis of pregnancy: is the bile acid level sufficient ?Hepatology.\u20082004;40:287\u2013288","DOI":"10.1002\/hep.20347"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/117\/5\/1669\/1070095\/zpe00506001669.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/117\/5\/1669\/1070095\/zpe00506001669.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,9]],"date-time":"2021-12-09T03:52:41Z","timestamp":1639021961000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/117\/5\/1669\/70038\/Intrahepatic-Cholestasis-of-Pregnancy-and-Neonatal"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2006,5,1]]},"references-count":18,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2006,5,1]]},"published-print":{"date-parts":[[2006,5,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2005-1801","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2006,5,1]]}}}