Exploring the impact of sleep quality on intrahepatic cholestasis of pregnancy

Abstract

Objective: To explore the association of poor sleep quality with the development of intrahepatic cholestasis of pregnancy (ICP). Methodology: This prospective cohort study was con-ducted at Islamic International Medical college in col-laboration with Rawalpindi Medical University. We en-rolled 182 pregnant women between the ages of 20-40 years, from Railway Hospital and Holy Family Hospi-tal, in their second trimester. Sleep quality was deter-mined using Pittsburgh Sleep Quality Index (PSQI). The participants were divided into two groups: Group I, n = 113 (good sleep quality), and Group II, n=69 (poor sleep quality). Blood samples were withdrawn for Ala-nine transaminase (ALT), Aspartate transaminase (AST), Alkaline phosphatase (ALP), bilirubin and fast-ing Total bile acids (TBA) to establish their baseline values. During their third trimester (between 28th to 36th week), same tests were repeated. History of pruritus, a main symptom of ICP was also explored. Differences between continuous and categorical variables among two groups were evaluated using the Mann-Whitney U test and Chi-square test, respectively. Regression anal-ysis was also employed. Results: Significant differences in liver enzymes and TBA were found between the two groups (p<0.001). A significant correlation of sleep score with ALT, AST, ALP, TBA and age (p<0.05) was found. Significantly higher proportion of participants who developed disease in the third trimester were in group II as compared to group I (p=0.000). Logistic regression analysis showed that poor sleep quality was an independent risk factor for the development of ICP (OR:1.410, p=0.01). Conclusion: The study concluded that poor sleep qual-ity is an independent risk factor for the development of ICP in pregnancy.