Toxic effects of elevated bile acid levels on fetal myocardium in intrahepatic cholestasis of pregnancy?from a neonatal perspective

Abstract

IntroductionIntrahepatic cholestasis of pregnancy (ICP) is a liver disease which may lead to a sudden fetal death. Previous studies have suggested that the fetal accident may be related to their cardiac dysfunction. However, the relationship between fetal cardiac dysfunction and their maternal bile acid levels is not clear. The objective was to clarify the relationship from a neonatal perspective and to furtherly make clear the after-effect by analysing the cardiac parameters of the older neonates. Materials and methodsIn this case-control study, patients and their neonates, managed between 10 September 2018 and 30 June 2021 at a Chinese university hospital center, were divided into severe ICP group, mild ICP group and control gestational group. The maternal bile acid levels and the cardiac paramerers of one-day-old neonates and five-day-old neonates were analysed, respectively. ResultsThe specific-myocardial enzyme(CK-MB) and left ventricular fraction shortening(FS) of neonates showed significant differences between ICP group and control group, and were meaningfully correlated with maternal bile acid levels. However, There was no significant difference in cardiac injury parameters of older neonates between the ICP and control groups. ConclusionsThe elevated maternal bile acid levels can lead to fetal myocardial injury and the injury can be recovered after removel from high concentrations of bile acid.