LAUSR

817 Correlation of bile acids and aspartateaminotransferase with adverse perinatal outcomes in intrahepatic cholestasis of pregnancy Alexander L. Juusela, Leah Cordero, Martin L. Gimovsky, Munir Nazir Newark Beth Israel Medical Center, Newark, NJ OBJECTIVE: To identify laboratory data that correlate with a nonreassuring prognosis and poor obstetrical and neonatal outcomes. STUDY DESIGN: A retrospective review of women with intrahepatic cholestasis of pregnancy (ICP), admitted for delivery between January 1, 2013 and December 31, 2017, was performed. Chi-square and Student’s T-test statistical analysis was performed, and receiver-operator characteristic curves were plotted for the prediction of each category of perinatal outcome and the areas under the curves were determined. All p-values were two-sided, and P <0.05 was considered statistically significant. RESULTS: Examination of the pregnancy outcomes and clinical features of the 61 patients diagnosed with ICP showed no occurrence of IUFD, stillbirth, abruption, or neonatal demise. In our cohort, no single factor was identified that correlated with a reassuring outcome and would permit expectant management of pregnancy beyond 37 weeks gestation. ROC curve analysis revealed a statistically significant correlation between bile acid and AST levels and perinatal outcomes. A bile acid level equal to or greater than 37 mmol/L strongly predicted spontaneous preterm labor in women affected by ICP with a sensitivity of 100% and specificity of 60.70% (P value 0.002). A bile acid level equal to or greater than 42 mmol/L strongly predicted meconiumstained amniotic fluid with a sensitivity of 85.70% and specificity of 66.70% (P value 0.006). AST levels equal to or greater than 62 IU/L strongly predicted NICU admission with a sensitivity of 81.30% and specificity of 62.20% (P value 0.002). AST levels equal to or greater than 75 IU/L strongly predicted hyperbilirubinemia in the neonates with a sensitivity of 87.50% and specificity of 69.80% (P value 0.001).