Authors
Lvping Gu, Jie Shen
Published in
The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians. Volume 39. Issue 1. Pages 2680355. Epub Jul 02, 2026.
Abstract
Intrahepatic cholestasis of pregnancy (ICP) is linked with adverse perinatal outcomes; however, its impact in twin pregnancies remains unclear. This systematic review and meta-analysis aimed to evaluate maternal and neonatal outcomes in twin pregnancies complicated by ICP.
A comprehensive search of PubMed, Embase, Web of Science, and Scopus was conducted from inception to 14 February 2026. Cohort studies comparing twin pregnancies with and without ICP were included. Random-effects meta-analyses were performed to assess maternal and neonatal outcomes reported by at least three studies.
Seven retrospective cohort studies were included. ICP in twin pregnancies was associated with increased risk of cesarean delivery, preeclampsia, and gestational diabetes mellitus. Preterm birth (PTB) <37 weeks was significantly increased with ICP in both crude and adjusted analysis. Mean gestational age was significantly reduced, and birthweight was lower in ICP. ICP was strongly associated with meconium-stained amniotic fluid and increased neonatal intensive care unit (NICU) admission. However, no significant association was noted between ICP and stillbirth, small-for-gestational age and postpartum hemorrhage.
ICP in twin pregnancies is associated with PTB and increased maternal and neonatal morbidity. Current evidence is derived mostly from crude data and from a limited number of studies with high inter-study heterogeneity.
PMID:
42392869
Bibliographic data and abstract were imported from PubMed on 03 Jul 2026.
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