Chen Hui, Zhou Yuan, Deng Dong-Rui, Hao Hai-Yan, Dang Jing, Li Jing
Department of Obstetrics and Gynecology, Tongji Hosptial, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
Department of Obstetrics, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, 530021, China.
J Huazhong Univ Sci Technolog Med Sci. 2013 Jun;33(3):412-417. doi: 10.1007/s11596-013-1133-8. Epub 2013 Jun 17.
This study aimed to identify biochemical predictors of adverse perinatal outcomes in intrahepatic cholestasis of pregnancy (ICP). A total of 106 ICP cases were analyzed retrospectively by the combination of receiver operating characteristic curve and binary logistic regression analysis. "Adverse perinatal outcomes" included spontaneous preterm labor, meconium-staining of amniotic fluid, stillbirth and Apgar score ≤7 at 1 or 5 min. Total bile acid (TBA) [AUC=0.658, 95%CI (0.536, 0.781), P=0.031] was a valuable predictor for adverse perinatal outcomes. The critical value of TBA above which adverse perinatal outcomes were observed was 40.15 μmol/L (Youden's index=0.3). Binary multivariate logistic regression analysis revealed that the risk of adverse perinatal outcomes increased when TBA ≥40.15 μmol/L [OR=3.792, 95%CI (1.226, 11.727), P=0.021]. It is concluded that the risk of adverse perinatal outcomes in ICP increases when maternal TBA ≥40.15 μmol/L.
本研究旨在确定妊娠肝内胆汁淤积症（ICP）围产期不良结局的生化预测指标。通过结合受试者工作特征曲线和二元逻辑回归分析，对106例ICP病例进行了回顾性分析。“围产期不良结局”包括自发性早产、羊水胎粪污染、死产以及1分钟或5分钟时阿氏评分≤7分。总胆汁酸（TBA）[AUC=0.658，95%CI（0.536，0.781），P=0.031]是围产期不良结局的一个有价值的预测指标。观察到围产期不良结局时TBA的临界值为40.15μmol/L（约登指数=0.3）。二元多变量逻辑回归分析显示，当TBA≥40.15μmol/L时，围产期不良结局的风险增加[OR=3.792，95%CI（1.226，11.727），P=0.021]。结论是，当母体TBA≥40.15μmol/L时，ICP围产期不良结局的风险增加。
