Prevalence of intrahepatic cholestasis of pregnancy in La Paz, Bolivia

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Abstract

A past history of intrahepatic cholestasis of pregnancy—either as cholestatic jaundice or as pruritus gravidarum—was inquired in 304 pregnant women examined in La Paz, Bolivia. Pruritus gravidarum was detected in 9.2% of them but no cases of cholestatic jaundice of pregnancy were found in the sample studied. This prevalence rate of pruritus gravidarum is considerably greater than that reported in European and North American populations (0.2–3.0%) but smaller than in Araucanian Indian-mixed (22.1%) and in Caucasoids (12.6%) previously studied in Chile. No significant differences in prevalence rates of pruritus gravidarum were found between the four ethnic groups (Aimara Indian. Quechua Indian, Indian-mixed and Caucasoids) in which Bolivian women were classified. Bolivian and Chilean Caucasoids showing a greater degree of ethnic admixture with South American Indian groups in their ancestry, had a greater prevalence and recurrence rate of intrahepatic cholestasis of pregnancy than Caucasoid women showing a smaller degree of ethnic admixture with native Indian groups.

We propose that the prevalence of intrahepatic cholestasis of pregnancy in Bolivia and in Chile is influenced by a genetic predisposition related to ethnic admixture with some South American Indian groups. Still unidentified environmental factors may modify the expressivity of the disease.

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    Grants from the University of Chile (M039-782), the Comisión Nacional de Investigación Científica (CONICYT), Chile, and the Comité Nacional Coordinador del Desarrollo de Ciencias Biológicas (CONDECIB), Bolivia.

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