The frequency of intrahepatic cholestasis of pregnancy among Pakistani women and its association with adverse maternal and neonatal outcomes; A cross sectional study at Agha khan university hospital

Submission: 01 October 2025 | Acceptance: 20 November 2025 | Publication: 07 December 2025

Tehreem Khalid¹, Farheen Yousaf²

Agha khan University Hospital¹ 

ABSTRACT

OBJECTIVE

To determine the frequency of intrahepatic cholestasis of pregnancy among Pakistani women and to evaluate its maternal and neonatal outcomes in a tertiary care setting in Karachi.

METHODOLOGY

This cross-sectional study was conducted in the Department of Obstetrics and Gynaecology, Aga Khan University Hospital, Karachi, and included 186 pregnant women diagnosed with intrahepatic cholestasis of pregnancy. Data on maternal and neonatal outcomes such as preterm birth, meconium-stained liquor, and NICU admission were collected using a structured proforma. Statistical analysis was performed using SPSS version 26.0, applying Chi-square with p ≤ 0.05 considered significant.   

RESULTS

Among 186 Pakistani women with intrahepatic cholestasis of pregnancy, the mean age was 30.1±4.6 years, and 60.2% were multigravida. Elevated ALT (>35 IU/L) was found in 93.5% and raised bile acids in 87.1% of patients. Caesarean delivery occurred in 47.3%, GDM in 50.5%, and PPH in 16.7%. Foetal outcomes included preterm birth (29.6%), low birth weight (18.3%), and NICU admission (14.5%).

CONCLUSION

Intrahepatic cholestasis of pregnancy was found to be associated with significant maternal and neonatal complications. The most frequent maternal outcomes included gestational diabetes, caesarean delivery, and postpartum haemorrhage, while preterm birth, low birth weight, and NICU admission were the predominant neonatal outcomes. Early diagnosis, close biochemical monitoring, and timely obstetric intervention are essential to improve perinatal outcomes and reduce complications among affected Pakistani women.

KEYWORDS

Intrahepatic Cholestasis of Pregnancy, Maternal Outcomes, Neonatal Outcomes, Pregnancy Complications, Liver