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Does ICP Impact on Glucose Tolerance, Dyslipidemia and Fetal Growth in Pregnancy?

Researchers measured the changes in glucose and lipid concentrations in women with intrahepatic cholestasis of pregnancy (ICP) and studied the influence on fetal growth….

A team of British and American researchers conducted a prospective study comparing metabolic outcomes in cholestastic and uncomplicated singleton pregnancies at two university hospitals in the U.K. and U.S. from 2011–2014. A total of 26 women with ICP and 27 control pregnancies with no prior history of gestational diabetes mellitus were recruited from outpatient antenatal services and followed until delivery. Alterations in glucose, incretins, cholesterol, and triglycerides were studied using a continuous glucose monitoring (CGM) system and/or a standard glucose tolerance test (GTT) in conjunction with GLP-1 and a fasting lipid profile. Fetal growth was quantified using adjusted birth centiles.

Maternal blood glucose concentrations were significantly increased in ICP during ambulatory CGM (P < 0.005) and following a GTT (P < 0.005). ICP is characterized by increased fasting triglycerides (P < 0.005) and reduced HDL cholesterol (P < 0.005), similar to changes observed in metabolic syndrome. The offspring of mothers with ICP had significantly larger customized birth weight centiles, adjusted for ethnicity, sex, and gestational age (P < 0.005).

The research team concluded that, “ICP is associated with impaired glucose tolerance, dyslipidemia, and increased fetal growth. These findings may have implications regarding the future health of affected offspring.”

Practice Pearls:

  • Posprandial plasma glucose levels were higher in ICP women compared with uncomplicated pregnancy
  • Adjusted birth weight centiles were significantly elevated in ICP
  • ICP has a positive impact on fetal growth than in uncomplicated pregnancy

Marcus Martineau. The metabolic profile of intrahepatic cholestasis of pregnancy is associated with impaired glucose tolerance, dyslipidemia, and increased fetal growth. Diabetes Care Feb 2015. Publ online before print December 12, 2014, doi: 10.2337/dc14-2143