{
  "abstract": "Background: Peak total bile acids guide management of intrahepatic cholestasis of pregnancy (ICP), potentially influencing observed outcomes. We examined their association with a composite adverse perinatal outcome (CAPO) excluding preterm delivery. Methods: This retrospective cohort included 280 singleton pregnancies with ICP delivered at a tertiary hospital between January 2023 and May 2026. Peak bile acids were categorized as <40, 40–99, or ≥100 µmol/L. CAPO comprised meconium-stained amniotic fluid, nonreassuring fetal status, neonatal intensive care admission, respiratory distress syndrome, transient tachypnea, neonatal death, or intrauterine fetal death. Logistic regression and receiver operating characteristic analysis were performed; the exploratory threshold maximized the Youden index. Results: The categories included 185, 70, and 25 pregnancies, with CAPO in 31 (16.8%), 19 (27.1%), and 19 (76.0%), respectively (p < 0.001). In the ≥100 µmol/L group, the exact 95% confidence interval for CAPO was 54.9–90.6%. The apparent area under the curve was 0.700 (95% confidence interval 0.625–0.772). The 61.3 µmol/L threshold yielded 50.7% sensitivity and 83.9% specificity. Peak bile acids per 10 µmol/L (adjusted odds ratio 1.20, 95% confidence interval 1.11–1.31) and hypertensive disorders (3.27, 1.30–8.23) were independently associated with CAPO. Conclusions: Peak bile acids showed moderate discrimination within this managed cohort. The ≥100 µmol/L subgroup had higher morbidity but imprecise estimates. The same-cohort-derived 61.3 µmol/L threshold is exploratory and requires independent validation; it should not determine delivery timing.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Obstetrics and Gynecology, Ankara Etlik City Hospital, Ankara 06170, Türkiye",
    "Department of Perinatology, Ankara Etlik City Hospital, Ankara 06170, Türkiye"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Türkan Dikici Aktaş"
    },
    {
      "affs": [
        1
      ],
      "name": "Özgür Volkan Akbulut",
      "orcid": "0000-0002-1960-2146"
    },
    {
      "affs": [
        1
      ],
      "name": "Bengisu Elüstü Çakır"
    },
    {
      "affs": [
        0
      ],
      "name": "Emel Özalp",
      "orcid": "0009-0004-9313-5250"
    },
    {
      "affs": [
        0
      ],
      "name": "Belgin Savran Üçok"
    },
    {
      "affs": [
        1
      ],
      "name": "Şevki Çelen"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/djhmt48mebnh6.bib",
  "cited_by": 0,
  "doi": "10.3390/jcm15207837",
  "fulltext_url": "https://europepmc.org/articles/PMC13704974",
  "id": "djhmt48mebnh6",
  "issns": [
    "2077-0383"
  ],
  "landing_url": "https://www.mdpi.com/2077-0383/15/20/7837",
  "language": "eng",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2729|Maternal and Perinatal Health Interventions"
    ]
  ],
  "openalex": "W7221523286",
  "pdf_url": "https://europepmc.org/articles/PMC13704974?pdf=render",
  "pmcid": "PMC13704974",
  "pmid": "42941354",
  "published": "2026-10-11",
  "publisher": "MDPI AG",
  "ris": "https://research.draconitic.com/paper/djhmt48mebnh6.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:00Z",
      "native_id": "10.3390/jcm15207837",
      "source": "crossref",
      "url": "https://www.mdpi.com/2077-0383/15/20/7837"
    },
    {
      "first_seen": "2026-10-30T12:22:24Z",
      "native_id": "MED:42941354",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42941354"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2729|Maternal and Perinatal Health Interventions",
      "subfield": "reproductive-child"
    }
  ],
  "title": "Peak Total Bile Acids and Adverse Perinatal Outcomes in Intrahepatic Cholestasis of Pregnancy: A Retrospective Cohort Study with Threshold Analysis",
  "title_text": "Peak Total Bile Acids and Adverse Perinatal Outcomes in Intrahepatic Cholestasis of Pregnancy: A Retrospective Cohort Study with Threshold Analysis",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:22:24Z",
  "url": "https://research.draconitic.com/paper/djhmt48mebnh6",
  "venue": "Journal of Clinical Medicine",
  "versions": []
}