{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T15:12:52Z","timestamp":1764947572803,"version":"3.46.0"},"reference-count":25,"publisher":"FapUNIFESP (SciELO)","issue":"11","license":[{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev. Assoc. Med. Bras."],"abstract":"<jats:p>SUMMARY  OBJECTIVE: The aim of this study was to compare maternal plasma soluble urokinase plasminogen activator receptor levels in pregnant women diagnosed with intrahepatic cholestasis of pregnancy with those in healthy pregnant women and to evaluate its predictive value for neonatal intensive care unit admission.  METHODS: This study is a prospective case-control study and was conducted with a total of 80 participants, including 38 pregnant women with intrahepatic cholestasis of pregnancy and 42 healthy pregnant women between 28 and 37 weeks of gestation. To evaluate the predictive value of maternal suPAR and bile acid levels for neonatal intensive care unit admission, receiver operating characteristic curves were generated.  RESULTS: Maternal serum alanine aminotransferase, aspartate aminotransferase, and direct bilirubin levels were statistically significantly higher in the intrahepatic cholestasis of pregnancy group compared to the control. In the intrahepatic cholestasis of pregnancy group, the plasma soluble urokinase plasminogen activator receptor level was 0.42\u00b10.6 ng\/mL, whereas in the control group it was 0.18\u00b10.1 ng\/mL (p=0.038). The intrahepatic cholestasis of pregnancy group delivered at an earlier gestational age and with lower birth weight, and the need for neonatal intensive care unit admission was statistically significantly higher. In both the severe and mild intrahepatic cholestasis of pregnancy groups, spontaneous preterm birth was more frequent than iatrogenic preterm birth. In the severe intrahepatic cholestasis of pregnancy group, there was one neonatal death and one meconium-stained birth. The discriminatory power of soluble urokinase plasminogen activator receptor levels in predicting neonatal intensive care unit need was found to be statistically significant (area under the curve: 0.757; 95%CI 0.552\u20130.962; p=0.022).  CONCLUSION: High maternal plasma soluble urokinase plasminogen activator receptor levels may predict adverse pregnancy outcomes.<\/jats:p>","DOI":"10.1590\/1806-9282.20251109","type":"journal-article","created":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T15:10:29Z","timestamp":1764947429000},"source":"Crossref","is-referenced-by-count":0,"title":["Maternal soluble urokinase plasminogen activator receptor levels in intrahepatic cholestasis of pregnancy: a predictor of neonatal intensive care unit admission"],"prefix":"10.1590","volume":"71","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4523-011X","authenticated-orcid":false,"given":"Bet\u00fcl Akg\u00fcn","family":"Akta\u015f","sequence":"first","affiliation":[{"name":"U\u015fak Education and Research Hospital,  Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8726-1075","authenticated-orcid":false,"given":"Zahid","family":"Agaoglu","sequence":"additional","affiliation":[{"name":"Ankara City Hospital,  Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-3726-2117","authenticated-orcid":false,"given":"Bet\u00fcl Nur","family":"Peker","sequence":"additional","affiliation":[{"name":"Ankara City Hospital,  Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5062-3316","authenticated-orcid":false,"given":"Ezgi","family":"Ba\u015faran","sequence":"additional","affiliation":[{"name":"Ankara City Hospital,  Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3974-9417","authenticated-orcid":false,"given":"Nazl\u0131","family":"Orhan","sequence":"additional","affiliation":[{"name":"Ankara City Hospital,  Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-6644-3890","authenticated-orcid":false,"given":"Burcu Bozkurt","family":"\u00d6zdal","sequence":"additional","affiliation":[{"name":"Ankara City Hospital,  Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8567-9048","authenticated-orcid":false,"given":"Dilek","family":"\u015eahin","sequence":"additional","affiliation":[{"name":"Ankara City Hospital,  Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"530","published-online":{"date-parts":[[2025]]},"reference":[{"issue":"2","key":"ref1","first-page":"B2","article-title":"Electronic address: pubs@smfm.org, Lee RH, Mara Greenberg None, Metz TD, Pettker CM. Society for Maternal-fetal medicine consult series #53: intrahepatic cholestasis of pregnancy: replaces consult #13, April 2011","volume":"224","year":"2021","journal-title":"Am J Obstet Gynecol"},{"issue":"1","key":"ref2","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1007\/s12072-023-10604-y","article-title":"Intrahepatic cholestasis of pregnancy: insights into pathogenesis and advances in omics studies","volume":"18","author":"Tang M","year":"2024","journal-title":"Hepatol Int"},{"issue":"1","key":"ref3","doi-asserted-by":"crossref","first-page":"20833","DOI":"10.1038\/s41598-022-22199-9","article-title":"Diagnostic and prognostic value of blood inflammation and biochemical indicators for intrahepatic cholestasis of pregnancy in Chinese pregnant women","volume":"12","author":"Luo M","year":"2022","journal-title":"Sci Rep"},{"issue":"1","key":"ref4","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1097\/GRF.0000000000000495","article-title":"Intrahepatic cholestasis of pregnancy","volume":"63","author":"Smith DD","year":"2020","journal-title":"Clin Obstet Gynecol"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/bs.acc.2024.04.005","article-title":"suPAR in cardiovascular disease","volume":"121","author":"Montecillo J","year":"2024","journal-title":"Adv Clin Chem"},{"issue":"4","key":"ref6","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1159\/000524965","article-title":"suPAR: an inflammatory mediator for kidneys","volume":"8","author":"Sudhini YR","year":"2022","journal-title":"Kidney Dis (Basel)"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1186\/1741-7015-10-2","article-title":"suPAR as a prognostic biomarker in sepsis","volume":"10","author":"Donadello K","year":"2012","journal-title":"BMC Med"},{"issue":"6","key":"ref8","doi-asserted-by":"crossref","first-page":"1167","DOI":"10.3390\/biomedicines12061167","article-title":"Urokinase-type plasminogen activator receptor (uPAR) in inflammation and disease: a unique inflammatory pathway activator","volume":"12","author":"Hamada M","year":"2024","journal-title":"Biomedicines"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"780641","DOI":"10.3389\/fimmu.2021.780641","article-title":"Soluble urokinase plasminogen activator receptor (suPAR) as a biomarker of systemic chronic inflammation","volume":"12","author":"Rasmussen LJH","year":"2021","journal-title":"Front Immunol"},{"issue":"11","key":"ref10","doi-asserted-by":"crossref","first-page":"935","DOI":"10.1080\/09513590.2022.2119957","article-title":"Maternal serum Sortilin-1 level as a potential biomarker for intrahepatic cholestasis of pregnancy","volume":"38","author":"Erta\u015f S","year":"2022","journal-title":"Gynecol Endocrinol"},{"issue":"11","key":"ref11","doi-asserted-by":"crossref","first-page":"1873","DOI":"10.1515\/cclm.2011.656","article-title":"Soluble urokinase plasminogen activator receptor (suPAR) levels in healthy pregnancy and preeclampsia","volume":"49","author":"Toldi G","year":"2011","journal-title":"Clin Chem Lab Med"},{"issue":"4","key":"ref12","doi-asserted-by":"crossref","first-page":"101","DOI":"10.14740\/jcgo418w","article-title":"Serum levels of soluble urokinase plasminogen activator receptor are elevated in severe pre-eclampsia","volume":"5","author":"Jalkanen V","year":"2017","journal-title":"J Clin Gynecol Obstetr"},{"issue":"10","key":"ref13","doi-asserted-by":"crossref","first-page":"1226","DOI":"10.1111\/j.1600-0412.2012.01504.x","article-title":"Serum soluble urokinase plasminogen activator receptor (suPAR) in early pregnancy prior to clinical onset of preeclampsia","volume":"91","author":"Odden N","year":"2012","journal-title":"Acta Obstet Gynecol Scand"},{"issue":"4","key":"ref14","doi-asserted-by":"crossref","first-page":"907","DOI":"10.1007\/s10753-013-9619-x","article-title":"Inflammatory markers in the second trimester prior to clinical onset of preeclampsia, intrauterine growth restriction, and spontaneous preterm birth","volume":"36","author":"Haedersdal S","year":"2013","journal-title":"Inflammation"},{"issue":"1","key":"ref15","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1186\/s12884-023-06221-0","article-title":"Soluble urokinase plasminogen activator receptor in vaginally collected amniotic fluid predicting fetal inflammatory response syndrome: a prospective cohort study","volume":"24","author":"Gulbiniene V","year":"2024","journal-title":"BMC Pregnancy Childbirth"},{"issue":"10","key":"ref16","doi-asserted-by":"crossref","first-page":"3175","DOI":"10.1007\/s43032-024-01678-6","article-title":"Novel biomarkers: soluble urokinase-type plasminogen activator receptor and procalcitonin- and histological chorioamnionitis after preterm premature rupture of membranes","volume":"31","author":"Jalkanen K","year":"2024","journal-title":"Reprod Sci"},{"issue":"1","key":"ref17","doi-asserted-by":"crossref","first-page":"13783","DOI":"10.1038\/s41598-019-50405-8","article-title":"Diagnostic and prognostic value of soluble urokinase-type plasminogen activator receptor (suPAR) in focal segmental glomerulosclerosis and impact of detection method","volume":"9","author":"Winnicki W","year":"2019","journal-title":"Sci Rep"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"109091","DOI":"10.1016\/j.clim.2022.109091","article-title":"Soluble urokinase Plasminogen Activator Receptor (suPAR) levels are predictive of COVID-19 severity: an Italian experience","volume":"242","author":"Infantino M","year":"2022","journal-title":"Clin Immunol"},{"key":"ref19","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1016\/j.clinbiochem.2019.05.010","article-title":"Analytical, biochemical and clearance considerations of soluble urokinase plasminogen activator receptor (suPAR) in healthy individuals","volume":"69","author":"Chew-Harris J","year":"2019","journal-title":"Clin Biochem"},{"issue":"2","key":"ref20","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1111\/liv.12705","article-title":"Serum soluble urokinase plasminogen activator receptor as a screening test for the early diagnosis of hepatocellular carcinoma","volume":"35","author":"Chounta A","year":"2015","journal-title":"Liver Int"},{"issue":"9","key":"ref21","doi-asserted-by":"crossref","first-page":"1330","DOI":"10.1111\/liv.12512","article-title":"Clinical relevance and cellular source of elevated soluble urokinase plasminogen activator receptor (suPAR) in acute liver failure","volume":"34","author":"Koch A","year":"2014","journal-title":"Liver Int"},{"key":"ref22","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12979-018-0141-8","article-title":"Healthy lifestyles reduce suPAR and mortality in a Danish general population study","volume":"16","author":"Haupt TH","year":"2019","journal-title":"Immun Ageing"},{"issue":"12","key":"ref23","article-title":"Severe intrahepatic cholestasis pregnancy is associated with maternal endothelial dysfunction: a case-control study","volume":"14","author":"K\u0131rlang\u0131\u00e7 MM","year":"2022","journal-title":"Cureus"},{"issue":"3","key":"ref24","doi-asserted-by":"crossref","first-page":"979","DOI":"10.1002\/ijgo.15107","article-title":"Evaluation of maternal serum vascular endothelial growth factor C and D levels in intrahepatic cholestasis of pregnancy","volume":"164","author":"Fariso\u011fullari N","year":"2024","journal-title":"Int J Gynaecol Obstet"},{"issue":"10174","key":"ref25","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1016\/S0140-6736(18)31877-4","article-title":"Association of adverse perinatal outcomes of intrahepatic cholestasis of pregnancy with biochemical markers: results of aggregate and individual patient data meta-analyses","volume":"393","author":"Ovadia C","year":"2019","journal-title":"Lancet"}],"container-title":["Revista da Associa\u00e7\u00e3o M\u00e9dica Brasileira"],"original-title":[],"link":[{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_pdf&pid=S0104-42302025001100617&tlng=en","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T15:10:33Z","timestamp":1764947433000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&pid=S0104-42302025001100617&tlng=en"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025]]},"references-count":25,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2025]]}},"alternative-id":["S0104-42302025001100617"],"URL":"https:\/\/doi.org\/10.1590\/1806-9282.20251109","relation":{},"ISSN":["1806-9282","0104-4230"],"issn-type":[{"value":"1806-9282","type":"electronic"},{"value":"0104-4230","type":"print"}],"subject":[],"published":{"date-parts":[[2025]]},"article-number":"e20251109"}}