Mother’s intrahepatic cholestasis does not affect her daughter’s health

Tiina Vimpeli, Kaisa Turunen, Kristiina Helander, Kari J. Mattila, Markku Sumanen

Department of General Practice, School of Medicine, University of Tampere, Tampere, Finland;.

DOI: 10.4236/health.2013.56A1005                

Abstract

Objective: To establish whether a mother’s intrahepatic cholestasis of pregnancy (ICP) has connections to her daughter’s health. Design: A retrospective study of daughters to ICP mothers. Setting: The region of Tampere University Hospital in Finland. Subjects: The study population comprised 575 women diagnosed with ICP during at least one pregnancy in the obstetric department of Tampere University Hospital in the period 1969-1988, and two controls chosen for each. Questionnaires were sent to these women and to their daughters: 305 daughters to ICP mothers and 642 to controls in autumn 2010. Eventually 187 daughters to ICP mothers responded (61.3%) and 373 to controls (58.1%). Main Outcome Measures: Evaluated health, symptoms and complaints, diagnosed diseases, mental health and use of medicines. Results: Only minor differences were detected between the two groups regarding the majority of items inquired. The only prominent difference between daughters to ICP mothers and those to controls concerned epilepsy, which was significantly more frequent among ICP mothers’ daughters, the prevalence being fourfold (3.2% vs 0.8%, p = 0.033). Conclusion: A mother’s ICP does not generally affect her daughter’s health. This can be considered an encouraging new finding for mothers with ICP in primary health care.

Keywords

Intrahepatic Cholestasis of Pregnancy; Inheritance; Epilepsy; Maternity Clinics; Primary Health Care

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Reyes, H. (1997) Intrahepatic cholestasis: A puzzling disorder of pregnancy. Journal of Gastroenterology and Hepatology, 12, 211-216. doi:10.1111/j.1440-1746.1997.tb00410.x
[2]	Reyes, H. and Sjovall, J. (2000) Bile acids and progesterone metabolites in intrahepatic cholestasis of pregnancy. Annals of Medicine, 32, 94-106. doi:10.3109/07853890009011758
[3]	Geenes, V. and Williamson, C. (2009) Intrahepatic cholestasis of pregnancy. World Journal of Gastroenterology, 15, 2049-2066. doi:10.3748/wjg.15.2049
[4]	Reyes, H. (2008) Sex hormones and bile acids in intrahepatic cholestasis of pregnancy. Hepatology, 47, 376- 379. doi:10.1002/hep.22139
[5]	Arrese, M. and Reyes, H. (2006) Intrahepatic cholestasis of pregnancy: A past and present riddle. Annals of Hepatology, 5, 202-205. http://www.medigraphic.com/pdfs/hepato/ah-2006/ah063r.pdf
[6]	Hay, J. and Eileen, E. (2008) Liver disease in pregnancy. Hepatology, 47, 1067-1076. doi:10.1002/hep.22130
[7]	Lammert, F., Marschall, H.U., Glantz, A. and Matern, S. (2000) Intrahepatic cholestasis of pregnancy: Molecular pathogenesis, diagnosis and management. Journal of Hepatology, 33, 1012-1021. doi:10.1016/S0168-8278(00)80139-7
[8]	Gonzalez, M.C., Reyes, H., Arrese, M., Figueroa, D., Lorca, B., Andresen, M., et al. (1989) Intrahepatic cholestasis of pregnancy in twin pregnancies. Journal of Hepatology, 9, 84-90. doi:10.1016/0168-8278(89)90079-2
[9]	Savander, M., Ropponen, A., Avela, K., Weerasekera, N., Cormand, B., Hirvioja, M.-L., et al. (2003) Genetic evidence of heterogeneity in intrahepatic cholestasis of pregnancy. Gut, 52, 1025-1029. doi:10.1136/gut.52.7.1025
[10]	Heinonen, S. and Kirkinen, P. (1999) Pregnancy outcome with intrahepatic cholestasis. Obstetrics & Gynecology, 94, 189-193. doi:10.1016/S0029-7844(99)00254-9
[11]	Kauppila A, Korpela H, Makila UM, Yrjanheikki E. Low serum selenium concentration and glutathione peroxidase activity in intrahepatic cholestasis of pregnancy. Br Med J 1987;294:150-2. http://dx.doi.org/10.1136/bmj.294.6565.150
[12]	Rioseco, A.J., Ivankovic, M.B., Manzur, A., Hamed, F., Kato, S.R., Parer, J.T., et al. (1994) Intrahepatic cholestasis of pregnancy: A retrospective case-control study of perinatal outcome. American Journal of Obstetrics & Gynecology, 170, 890-895. doi:10.1016/S0002-9378(94)70304-3
[13]	Bacq, Y. (2011) Liver diseases unique to pregnancy: A 2010 update. Clinics and Research in Hepatology and Gastroenterology, 35, 182-193. doi:10.1016/j.clinre.2010.11.011
[14]	Turunen, K., Sumanen, M., Haukilahti, R.L., Kirkinen, P. and Mattila, K. (2010) Good pregnancy outcome despite intrahepatic cholestasis. Scandinavian Journal of Primary Health Care, 28, 102-107. doi:10.3109/02813431003784001
[15]	Sigurdsson, J. (2003) The GP’s role in maternity care. Scandinavian Journal of Primary Health Care, 21, 65. doi:10.1080/02813430310000302302
[16]	Glantz, A., Marschall, H.U. and Mattsson, L.A. (2004) Intrahepatic cholestasis of pregnancy: Relationships between bile acid levels and fetal complication rates. Hepatology, 40, 467-474. doi:10.1002/hep.20336
[17]	Glantz, A., Marschall, H.U., Lammert, F. and Mattsson, L.A. (2005) Intrahepatic cholestasis of pregnancy: A randomized controlled trial comparing dexamethasone and ursodeoxycholic acid. Hepatology, 42, 1399-1405. doi:10.1002/hep.20952
[18]	Ropponen, A., Sund, R., Riikonen, S., Ylikorkala, O. and Aittomaki, K. (2006) Intrahepatic cholestasis of pregnancy as an indicator of liver and biliary diseases: A population-based study. Hepatology, 43, 723-728. doi:10.1002/hep.21111
[19]	Turunen, K., Molsa, A., Helander, K., Sumanen, M. and Mattila, K.J. (2012) Health history after intrahepatic cholestasis of pregnancy. Acta Obstetricia et Gynecologica Scandinavica, 91, 679-685. doi:10.1111/j.1600-0412.2012.01403.x
[20]	Holzbach, R.T., Sivac, D.A. and Braun, W.E. (1983) Familial recurrent intrahepatic cholestasis of pregnancy: A genetic study providing evidence for transmission of a sex-limited, dominant trait. Gastroenterology, 85, 175- 179. http://www.ncbi.nlm.nih.gov/pubmed/6852450
[21]	Reyes, H., Ribalta, J. and Gonzales-Ceron, M. (1976) Idiopathic cholestasis of pregnancy in a large kindred. Gut, 17, 709-713. doi:10.1136/gut.17.9.709
[22]	Hirvioja, M.-L. and Kivinen, S. (1993) Inheritance of intrahepatic cholestasis of pregnancy in one kindred. Clinical Genetics, 43, 315-317. doi:10.1111/j.1399-0004.1993.tb03826.x
[23]	Pauli-Magnus, C., Lang, T. and Meier, Y. (2004) Sequence analysis of bile salt export pump (ABCB11) and multidrug resistance p-glycoprotein 3 (ABCB4, MDR3) in patients with intrahepatic cholestasis of pregnancy. Pharmacogenetics, 14, 91-102. doi:10.1097/00008571-200402000-00003
[24]	Eloranta, M.-L., Hakli, T., Hiltunen, M., Helisalmi, S., Punnonen, K. and Heinonen, S. (2003) Association of single nucleotide polymorphisms of the bile salt export pump gene with intrahepatic cholestasis of pregnancy. Scandinavian Journal of Gastroenterology, 38, 648-652. doi:10.1080/00365520310000807
[25]	Müllenbach, R., Bennett, A., Tetlow, N. and Patel, N. (2005) ATP8B1 mutations in British cases with intrahepatic cholestasis of pregnancy. Gut, 54, 829-834. doi:10.1136/gut.2004.058115
[26]	Salokangas, R.K., Poutanen, O. and Stengard, E. (1995) Screening for depression in primary care. Development and validation of the depression scale, a screening instrument for depression. Acta Psychiatrica Scandinavica, 92, 10-16. doi:10.1111/j.1600-0447.1995.tb09536.x
[27]	Eriksson, L., Haglund, B., Ewald, U., Odlind, V. and Kieler, H. (2009) Short and long-term effects of antenatal corticosteroids assessed in a cohort of 7827 children born preterm. Acta Obstetricia et Gynecologica Scandinavica, 88, 933-938. doi:10.1080/00016340903111542
[28]	Sellier, E., Uldall, P., Calado, E., Sigurdardottir, S., Torrioli, M.G., Platt, M.J., et al. (2012) Epilepsy and cerebral palsy: Characteristics and trends in children born in 1976- 1998. European Journal of Paediatric Neurology, 16, 48- 55. doi:10.1016/j.ejpn.2011.10.003
[29]	Saigal, S. and Doyle, L.W. (2008) An overview of mortality and sequelae of preterm birth from infancy to adulthood. Lancet, 371, 261-269. doi:10.1016/S0140-6736(08)60136-1
[30]	Ross, E.M., Peckham, C.S., West, P.B. and Butler, N.R. (1980) Epilepsy in childhood: Findings from the National Child Development Study. British Medical Journal, 280, 207-210. doi:10.1136/bmj.280.6209.207
[31]	Molsa, A., Turunen, K., Mattila, K.J. and Sumanen, M. (2012) Unnecessary confusion about family planning after intrahepatic cholestasis of pregnancy. Contraception, 86, 639-644. doi:10.1016/j.contraception.2012.05.149