Abstract: Objective To evaluate the predictive value of serum Pentraxin 3 (PTX3), Sulfotransferase 2A1 (SULT2A1), and Adipocyte Fatty Acid Binding Protein (AFABP) for Intrahepatic Cholestasis of Pregnancy (ICP) and analyze its associated risk factors.Methods From August 2020 to August 2023, 100 patients with ICP treated at Changzhou Maternal and Child Health Hospital were included in the observation group, and 90 healthy pregnant women were included in the control group. Data were collected for both groups, and serum levels of PTX3, SULT2A1, and AFABP were measured. Multifactorial Logistic regression was performed to identify risk factors for ICP, and the predictive value of combined serum PTX3, SULT2A1, and AFABP levels was evaluated using Receiver Operating Characteristic (ROC) curves.Results The observation group showed significantly higher levels of ALT (79.24±5.78 U/L), AST (58.62±5.21 U/L), ALP (206.79±32.58 U/L), TBA (44.76±4.89 μmol/L), GGT (36.76±4.13 U/L), TBil (12.56±2.38 μmol/L), and DBil (5.92±1.45 μmol/L) compared to the control group (18.45±3.24 U/L, 20.38±3.36 U/L, 174.54±27.61 U/L, 5.01±1.02 μmol/L, 18.22±3.18 U/L, 10.49±2.15 μmol/L, 3.29±0.87 μmol/L; t=88.082, 59.389, 7.318, 75.631, 34.387, 6.265, 14.952, P<0.05). Risk factors for ICP included family history of ICP, hepatitis B virus infection, multiple pregnancies, gestational hypertension, and autoimmune diseases (P<0.05). In the observation group, serum levels of PTX3 (4.93±1.28 μg/L) and AFABP (35.24±9.24 μmol/L) were higher, while SULT2A1 (28.74±7.87 μg/L) was lower compared to the control group (3.27±1.02 μg/L, 21.22±7.45 μmol/L, 43.26±9.12 μg/L respectively; P<0.05). ROC analysis revealed that the sensitivity and specificity of serum PTX3, SULT2A1, AFABP levels, and their combined detection for predicting ICP were 68.0%, 80.0%, 83.0%, 95.0%, and 87.8%, 85.6%, 83.3%, 92.2% respectively, with AUCs of 0.845, 0.889, 0.891, 0.972.Conclusion Combined measurement of serum PTX3, SULT2A1, and AFABP levels demonstrates high sensitivity and specificity in predicting ICP, providing valuable support for early diagnosis and intervention.

Key words: Intrahepatic cholestasis of pregnancy, Pentraxin 3, Sulfotransferase 2A1, Adipocyte fatty acid binding protein