Are Complete Blood Count Indices Different in Twins with the Diagnosis of Intrahepatic Cholestasis of Pregnancy?

Objective: To compare complete blood count (CBC) indices in twin pregnancies with and without the diagnosis of intrahepatic cholestasis of pregnancy (ICP). Material and Methods: This study was a retrospective case-control study of twin pregnancies complicated with ICP. The study and control groups included 36 twin pregnancies in each, respectively. The study and control groups were compared with each other with respect to the CBC indices (primary outcome measures of the study), maternal and newborn characteristics and pregnancy outcomes (secondary outcome measures). Statistical analyses were performed by using SPSS for Windows, version 22.0. Results: There were significant differences between the study and control groups regarding mean maternal age and median gestational age at delivery (p<0.05). Mean birthweight was significantly lower in the study group compared to control group (p<0.001). Neonatal intensive care unit (NICU) admission was significantly more frequent in the study group than in the control group (75% vs 33.3%; p<0.001). The white blood cell (WBC), neutrophil and monocyte counts, neutrophil to lymphocyte ratios (NLRs) and monocyte to lymphocyte ratios (MLRs) were significantly lower, while mean platelet volume (MPV), aspartate aminotransferase (AST) and alanine aminotransferase (ALT) values were significantly higher in the study group than in the control group (p=0.002, p=0.001, p=0.004, p=0.008, p=0.006, p <= 0.001, p <= 0.001, p <= 0.001,, respectively). Conclusion: The NLRs and MLRs were significantly lower, while MPV was significantly higher in twin pregnancies with the diagnosis of ICP, than that of controls and ICP was found to be an independent predictor for increased MPV and decreased MLR values, irrespective of the other variables associated with MPV and MLR.