# The Potential Value of Blood Inflammatory Parameters in Diagnosing the Inflammatory Microenvironment and Predicting Fetal Outcomes in Patients With Intrahepatic Cholestasis of Pregnancy

## TL;DR

This study explores how blood inflammatory markers can help diagnose and predict outcomes in intrahepatic cholestasis of pregnancy.

## Contribution

The study identifies specific inflammatory markers and their predictive value for adverse fetal outcomes in ICP.

## Key findings

- ICP patients showed significantly higher levels of IL-6, IL-10, TNF-α, and IFN-γ compared to healthy controls.
- Combining inflammatory markers with TBA improved prediction accuracy for preterm birth and low fetal weight.
- MR analysis linked IL-2 and TNF-α to increased ICP risk.

## Abstract

Previous studies have indicated that the inflammatory microenvironment in pregnant women may contribute significantly to the development of intrahepatic cholestasis of pregnancy (ICP). However, the exact relationship between inflammatory blood parameters and ICP remains uncertain. This study aims to explore the relationship between serum inflammatory factors, inflammatory scoring indicators, and adverse pregnancy outcomes in ICP. Serum samples were collected after 25 weeks of gestation from women clinically diagnosed with ICP, as well as from gestational age‐matched healthy pregnant controls. Cytokine levels were subsequently measured using flow cytometry. Correlation analysis was conducted to explore potential relationships between blood inflammatory parameters and other ICP–related markers. Receiver operating characteristic (ROC) curves were generated to evaluate their predictive performance for adverse pregnancy outcomes. Mendelian randomization (MR) analysis was performed to examine potential causal links between inflammation and ICP development. The results revealed significant differences in serum levels of interleukin‐6 (IL‐6), interleukin‐10 (IL‐10), tumor necrosis factor‐α (TNF‐α), and interferon‐γ (IFN‐γ) between ICP patients and healthy controls. Additionally, inflammatory scoring indicators were significantly elevated in ICP patients. Most inflammatory parameters correlated with liver function indices and showed positive associations with total bile acids (TBAs). ROC analysis demonstrated that combining inflammatory markers with TBA improved the predictive accuracy for preterm birth (area under the ROC curve [AUC]: 0.865) and low fetal weight (AUC: 0.916). MR analysis identified interleukin‐2 (IL‐2) and TNF‐α as potential risk factors for ICP. Based on these findings, blood inflammatory parameters may serve as accessible and cost‐effective indicators for understanding the inflammatory microenvironment in ICP and predicting fetal outcomes.