A retrospective cohort study on perinatal outcomes of monochorionic and dichorionic twin pregnancies complicated by intrahepatic cholestasis of pregnancy.

Intrahepatic cholestasis of pregnancy (ICP) is the most common pregnancy-related liver disorder and may cause adverse perinatal outcomes. However, few studies reported differences in perinatal outcomes of monochorionic(MC) and dichorionic(DC) twin pregnancies complicated by ICP. These perinatal outcomes were assessed with a retrospective cohort study. This was a retrospective observational study of MC and DC twin pregnancies complicated by ICP. Cases were divided into the MC group and DC group, perinatal outcomes were compared, and predictors of adverse perinatal outcomes were evaluated. In total, 363 twin pregnancies complicated by ICP (93 MC, 270 DC) were included. Compared with DC twin pregnancies, MC pregnancies were characterized by younger age, lower pre-pregnancy weight and lower pre-pregnancy body mass index (p < 0.05). Delivery of MC twins was more likely to occur between 34 and 37 weeks, averaging 34.87 ± 2.42 gestational weeks. Additionally, both twins A and B in the MC group weighed less than those in the DC group (p < 0.001). After adjustment for confounders, GA at diagnosis < 32 weeks (aOR = 1.096, 95% CI 1.031-2.393, p = 0.000) was an independent risk factor in MC twin pregnancies, while GA at diagnosis < 32 weeks(aOR = 13.626, 95% CI 1.783-14.177, p = 0.012) and AST > 200 U/L (aOR = 3.178, 95% CI 1.252-8.068, p = 0.015) were independent risk factors for adverse perinatal outcomes in DC twin pregnancies. Our results indicated that some liver function biochemical indicators could predict poor foetal outcomes in twin pregnancies complicated by ICP. Greater emphasis should be placedon monitoring of predelivery liver functional biochemical indexes in pregnant women according to chorionicity complicated by ICP, to facilitate personalized antenatal management and improve neonatal outcomes.