By Will Boggs, MD
NEW YORK (Reuters Health) – Pregnant women who develop a
build-up of bile in the liver, a condition called intrahepatic
cholestasis of pregnancy (ICP), have babies with an increased
risk of developing respiratory distress syndrome, a potentially
fatal disease that occurs when the tiny air sacs of the lungs
collapse, according to a report in the journal Pediatrics.
ICP, the result of liver malfunction during pregnancy,
causes severe itching and, in some cases, jaundice. The
condition typically resolves after delivery, but it usually
recurs in any subsequent pregnancies.
“Neonatologists should give particular attention during the
first hours of life to these babies, monitoring respiratory
function if they are delivered before term or near term (even
at 37 – 38 weeks of gestation),” Dr. Enrico Zecca from Catholic
University of the Sacred Heart, Rome, told Reuters Health.
Zecca and colleagues investigated the rate of neonatal
respiratory distress syndrome after pregnancies complicated by
ICP and measured bile levels in the affected mothers and their
infants.
The rate of respiratory distress syndrome was about twice
as high in infants of mothers with ICP — 29 percent — as in
infants of mothers without ICP — 14 percent, the authors
report. Male gender was also significantly associated with the
occurrence of respiratory distress syndrome, the results
indicate.
Bile levels of mothers with ICP who delivered healthy
infants did not differ significantly from those of mothers who
delivered infants that developed respiratory distress syndrome,
the researchers note. Similarly, infants with respiratory
distress syndrome had bile levels that were similar to those of
healthy infants.
“Babies from mothers with ICP have a higher risk to develop
neonatal respiratory distress syndrome,” Zecca concluded.
“Obstetricians should take this into account when planning a
preterm delivery in ICP pregnancies, and neonatologists should
have particular clinical attention during the first hours of
life.”
SOURCE: Pediatrics, May 2006.
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