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This retrospective analysis compared clinical characteristics and outcomes of isolated ICP versus ICP concurrent with CHB across immune-tolerant, inactive, immune-active, and grey zone CHB groups. Women with ICP involving immune-active CHB showed the most severe biochemical abnormalities and adverse outcomes, whereas other CHB phases resembled isolated ICP. Elevated total bile acid (TBA) and immune-active CHB increased composite adverse outcomes, informing risk-tailored diagnosis and management.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":40,"@type":76,"position":81},"https://docshare.wps.com/document/research-report/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/clinical-outcomes-of-intrahepatic-cholestasis-of-pregnancy-with-versus-without-chronic-hepatitis-b-a-retrospective-analysis/442853/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/clinical-outcomes-of-intrahepatic-cholestasis-of-pregnancy-with-versus-without-chronic-hepatitis-b-a-retrospective-analysis/442853.png","ImageObject",300,407,{"name":92,"@type":93},"mieayamfan","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-09-30","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":14},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"How were isolated ICP and ICP involving chronic hepatitis B defined in the study?","Question",{"text":112,"@type":113},"Isolated ICP was defined as ICP without viral hepatitis. ICP involving chronic hepatitis B (CHB) required co-concurrence of ICP and CHB, categorized by CHB immune phase, with immune-active CHB used as a key subgroup and immune-active CHB with normal elevated total bile acid serving as controls.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"Which subgroup showed the worst biochemical abnormalities and pregnancy outcomes?",{"text":117,"@type":113},"Women with ICP involving immune-active CHB experienced the most severe biochemical abnormalities and the worst adverse pregnancy outcomes compared with other groups.",{"name":119,"@type":110,"acceptedAnswer":120},"What role did total bile acid (TBA) levels and immune status play in risks?",{"text":121,"@type":113},"Assisted reproductive technology, higher TBA levels, and immune-active CHB were associated with increased risks of composite adverse outcomes. TBA thresholds were linked to specific outcomes, including preterm birth, NICU admission, meconium-stained amniotic fluid, and lower Apgar scores.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},442853,1790765875,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":39,"category_name":40,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":14,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145},962090893677,"https://ap-avatar.wpscdn.com/davatar_3d24733baf745e90a7e4bdd5f77d97b2","DOI: 10.1097/HC9.0000000000000869  \nO R IG INAL ART ICL E  \nClinical outcomes of intrahepatic cholestasis of pregnancy with versus without chronic hepatitis B: A retrospective analysis  \nZhenyan Han | Xiaodan Chen | Yuan Zhang | Yan Guo | Min Du | Linlin Liu | Hongying Hou | Qingqing Wang | Lingling Wu  \nDepartment of Obstetrics and Gynecology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China  \nCorrespondence  \nLingling Wu, Department of Obstetrics and Gynecology, Third Affiliated Hospital of Sun Yatsen University, No. 2693 Kaichuang Avenue, Guangzhou, Guangdong 510530, China. [Email:](Email: wulling@mail.sysu.edu.cn)[ wulling@mail.sysu.edu.cn](Email: wulling@mail.sysu.edu.cn)  \nQingqing Wang, Department of Obstetrics and Gynecology, Third Affiliated Hospital of Sun Yatsen University, No. 600 Tianhe Road, Guangzhou, Guangdong 510630, China. [Email:](Email: wangqq25@mail.sysu.edu.cn)[ wangqq25@mail.sysu.edu.cn](Email: wangqq25@mail.sysu.edu.cn)  \n\n|  | Abstract |  |\n| --- | --- | --- |\n| | Background: Intrahepatic cholestasis of pregnancy (ICP) is a multifactorial liver disorder associated with adverse pregnancy outcomes. Chronic hepatitis B (CHB) has been reported with increased risk of ICP, while the clinical characteristics and outcomes of isolated ICP compared with ICP involving CHB remain poorly understood.\u003Cbr>Methods: ICP involving CHB was defined as the co-concurrence of ICP with CHB, categorized into immune-tolerant CHB (n = 44), inactive CHB (n = 86), immune-active CHB (n = 127), and grey zone CHB (n = 89) . Isolated ICP (n = 826) was defined as ICP without viral hepatitis, while immune-active CHB with normal elevated total bile acid (TBA) (n = 87) serves as controls. Results: Women with ICP involving immune-active CHB experienced the most severe biochemical abnormalities and adverse outcomes, whereas other CHB subgroups exhibited biochemical profiles and outcomes comparable to isolated ICP cases. Assisted reproductive technology (aOR, 1 .24), TBA levels (40–99.9 µmol/L-aOR, 1 .27, ≥ 100 µmol/L-aOR, 1 .60), and immune-active CHB (aOR, 1.12) were associated with increased risks of composite adverse outcomes. Stratified analysis revealed that TBA ≥ 40 µmol/L significantly correlated with increased risks of total and iatrogenic preterm birth and neonatal intensive care unit admission (p \u003C 0.05); while TBA ≥ 100 µmol/L was further associated with elevated risks of meconium-stained amniotic fluid and lower Apgar scores (p \u003C 0.05) . Immune-active CHB women with normal TBA demonstrated relatively higher |  |\n|  |  |  |\n\nAbbreviations: AASLD, Association for the Study of Liver Diseases; ALT, alanine transaminase; AST, aspartate aminotransferase; BMI, body mass index; CHB, chronic hepatitis B; HBeAg, hepatitis B e antigen; HBsAg, hepatitis B surface antigen; HBV, chronic hepatitis B virus; HELLP, Hemolysis, Elevated Liver enzymes, and Low platelets; ICP, intrahepatic cholestasis of pregnancy; MSAF, meconium-stained amniotic fluid; NICU, neonatal intensive care unit; TB, total bilirubin; TBA, total bile acid; ULN, upper limit of normal.  \nZhenyan Han and Xiaodan Chen contributed equally to this work.  \nSupplemental Digital Content is available for this article. Direct URL citations are provided in the HTML and PDF versions of this article on the journal's website, www.hepcommjournal.com.  \n-- ----- ----- ----- ----- ----- ----- ----- ----- ----- ----- ----- ----- ----- ----- ----- ----- ----- ----- ----- ----- -  \nThis is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.  \nCopyright © 2026 The Author(s) . Published by Wolters Kluwer Health, Inc. on behalf of the American Association for the Study of Liver Diseases.  \n\n|  |  | l","cbCair1Ap6Rp3aJ6","https://ap.wps.com/l/cbCair1Ap6Rp3aJ6","pdf",337835,14,"English","# Background\n# Methods\n# Results\n# Conclusions\n# Introduction\n# Abbreviations","[{\"question\":\"How were isolated ICP and ICP involving chronic hepatitis B defined in the study?\",\"answer\":\"Isolated ICP was defined as ICP without viral hepatitis. ICP involving chronic hepatitis B (CHB) required co-concurrence of ICP and CHB, categorized by CHB immune phase, with immune-active CHB used as a key subgroup and immune-active CHB with normal elevated total bile acid serving as controls.\"},{\"question\":\"Which subgroup showed the worst biochemical abnormalities and pregnancy outcomes?\",\"answer\":\"Women with ICP involving immune-active CHB experienced the most severe biochemical abnormalities and the worst adverse pregnancy outcomes compared with other groups.\"},{\"question\":\"What role did total bile acid (TBA) levels and immune status play in risks?\",\"answer\":\"Assisted reproductive technology, higher TBA levels, and immune-active CHB were associated with increased risks of composite adverse outcomes. TBA thresholds were linked to specific outcomes, including preterm birth, NICU admission, meconium-stained amniotic fluid, and lower Apgar scores.\"}]","Clinical outcomes of intrahepatic cholestasis of pregnancy with versus without chronic hepatitis B - A retrospective analysis | PDF",1790701865,35]