EVALUATION OF LIVER FUNCTION INDICES IN INTRAHEPATIC CHOLESTASIS OF PREGNANCY: DIAGNOSTIC UTILITY AND NEONATAL OUTCOMES

Aim: Intrahepatic cholestasis of pregnancy (ICP) is a hepatic condition that occurs in 0.2-2% of pregnancies. It is characterized by intense itching and increased levels of bile acids in the bloodstream. Precise identification and anticipation of adverse neonatal outcomes are crucial. This study evaluates the diagnostic performance of liver-related scores—APRI (aspartate aminotransferase- platelet), ALBI (albumin-bilirubin), PALBI (platelet- albumin-bilirubin), and FAR (fibrinogen/albumin ratio) —in ICP patients and examines their relationship to pregnancy outcomes. Material and Method: This study was a retrospective analysis of 180 patients who were treated at Ankara Etlik City Hospital between January 2023 and January 2024. 90 ICP patients (Group 1) and 90 control patients (Group 2) were compared. The PALBI, ALBI, APRI scores, and FAR were calculated using third-trimester laboratory values. Neonatal outcomes, including birth weight, APGAR scores, NICU (neonatal intensive care unit) admission, sepsis, RDS (respiratory distress syndrome), and neonatal death were recorded. Statistical analyses included ROC (Receiver Operating Characteristics) curve analysis and Spearman correlation. Results: The PALBI, ALBI, APRI scores, and FAR were significantly higher in ICP patients (p-2.58 for PALBI (sensitivity 62%, specificity 81%), >-2.47 for ALBI (sensitivity 67%, specificity 81%), and >0.3 for APRI (sensitivity 78%, specificity 68%). Neonatal outcomes did not differ significantly between the groups. There was no correlation between fasting bile acid levels and liver damage markers with negative outcomes in newborns. Conclusion: In facilities where it is not possible to test fasting bile acid levels, PALBI, ALBI, APRI scores and FAR value offer an alternative approach to the evaluation of individuals with intrahepatic cholestasis of pregnancy (ICP). Future studies with larger patient groups are needed to increase the reliability of these parameters.