Jin Jin, Pan Shi-lei, Huang Li-ping, Yu Yan-hong, Zhong Mei, Zhang Guo-wei
Department of Gynaecology and Obstetrics, NanFang Hospital, Southern Medical University, Guangzhou, China.
Department of Gynaecology and Obstetrics, ZhuJiang Hospital, Southern Medical University, Guangzhou, China.
Int J Gynaecol Obstet. 2015 Mar;128(3):236-40. doi: 10.1016/j.ijgo.2014.09.013. Epub 2014 Nov 8.
To determine risk factors for adverse fetal outcomes (AFOs) among women with intrahepatic cholestasis of pregnancy (ICP) on the basis of time of onset.
In a retrospective analysis, data were obtained for all women with ICP admitted to two centers in Guangzhou, China, between February 1, 1993, and January 31, 2014. Patients were divided into group A (early-onset ICP) and group B (late-onset ICP), and were further divided on the basis of severity. The frequency of AFOs was assessed.
Among 371 eligible women, 57 (15.4%) were in group A and 314 (84.6%) in group B. AFOs affected 20 (35.1%) women in group A and 67 (21.3%) in group B (P=0.024), and 12 (54.5%) of 22 women in group A and 21 (29.6%) of 71 in group B with severe ICP (P=0.032). Independent risk factors for AFO in group A were increased levels of serum bile acid (P=0.016) and alkaline phosphatase (P=0.004). Independent risk factors in group B were increased levels of alkaline phosphatase (P<0.001) and gamma-glutamyl transpeptidase (P=0.001).
Early-onset ICP is associated with a higher frequency of AFO than is late-onset ICP, especially in severe disease. The risk factors differ between early-onset and late-onset ICP.
根据发病时间确定妊娠肝内胆汁淤积症（ICP）孕妇不良胎儿结局（AFO）的危险因素。
在一项回顾性分析中，获取了1993年2月1日至2014年1月31日期间在中国广州两个中心收治的所有ICP孕妇的数据。患者被分为A组（早发型ICP）和B组（晚发型ICP），并根据严重程度进一步细分。评估AFO的发生频率。
在371名符合条件的女性中，A组有57名（15.4%），B组有314名（84.6%）。AFO影响了A组20名（35.1%）女性和B组67名（21.3%）女性（P = 0.024），以及A组22名严重ICP女性中的12名（54.5%）和B组71名中的21名（29.6%）（P = 0.032）。A组中AFO的独立危险因素是血清胆汁酸水平升高（P = 0.016）和碱性磷酸酶水平升高（P = 0.004）。B组的独立危险因素是碱性磷酸酶水平升高（P < 0.001）和γ-谷氨酰转肽酶水平升高（P = 0.001）。
早发型ICP比晚发型ICP发生AFO的频率更高，尤其是在严重疾病中。早发型和晚发型ICP的危险因素不同。
