The etiology of intrahepatic cholestasis of pregnancy remains controversial. A family history of the condition is common, and there is an association with the presence of human leukocyte antigen-A31 (HLA-A31) and HLA-B8. 1 , 18 The condition tends to recur in subsequent pregnancies. 1 Patients may have a family history of cholelithiasis and a higher risk of gallstones. 25 , 26 The condition is associated with a higher risk of premature delivery, meconium-stained amniotic fluid, and intrauterine demise. A prospective cohort study demonstrated a correlation between bile acid levels and fetal complications, with a statistically significant increase in adverse fetal outcomes reported in patients with bile acid levels of mcg per mL (40 μmol per L) or more. 25
The limitations of these data must be understood by HCPs and parents. They include: small sample sizes with wide confidence intervals at 22 and 23 weeks GA, an unknown number of children with one versus multiple impairments, variation in the definition and labelling of NDD by HCPs (especially ‘severe’ versus ‘moderate’) that may not reflect parents’ views or reality, no information on mild or other types of impairment (., behavioural) and the lack of correlation between degree of NDD and QOL  . One example demonstrates such limitations clearly: A child with severe cognitive impairment and severe cerebral palsy and a child with isolated uncorrectable deafness would both be classified as having severe NDD.
Short-term palliative treatment of acute episodes or exacerbations and systemic complications of rheumatic disorders (., rheumatoid arthritis, juvenile arthritis, psoriatic arthritis, acute gouty arthritis, posttraumatic osteoarthritis, synovitis of osteoarthritis, epicondylitis, acute nonspecific tenosynovitis, ankylosing spondylitis, Reiter syndrome † , rheumatic fever † [especially with carditis]) and collagen diseases (., acute rheumatic carditis, systemic lupus erythematosus, dematomyositis † [polymyositis], polyarteritis nodosa † , vasculitis † ) refractory to more conservative measures. a c d f