Hämäläinen Suvi-Tuulia, Turunen Kaisa, Mattila Kari J, Sumanen Markku
Department of General Practice, Faculty of Medicine and Life Sciences, University of Tampere, 33100, Tampere, Finland.
Janakkala Health Centre, Tapailanpiha 13 B, 14200, Turenki, Finland.
BMC Womens Health. 2018 Jun 19;18(1):98. doi: 10.1186/s12905-018-0606-0.
The aim of this study was to determine whether intrahepatic cholestasis of pregnancy (ICP) is associated with causes of death during on average 35 years follow-up after the delivery.
The study population comprised 571 women with ICP in at least one pregnancy seen at Tampere University Hospital, Finland, between 1969 and 1988. ICP was verified from patient records. The previous and following subjects in the maternity ward diary were taken as controls for each ICP case. In total, there were 1333 controls. All underlying causes of death were obtained from Statistics Finland in March 2017. The deaths occurred during 1971-2015 and the causes of death were classified according to ICD-10.
Altogether, 39 of the mothers with ICP (6.8%) and 111 of the controls (8.3%) had died by the end of 2015 (p = 0.267). There were more underlying causes of death from gastrointestinal diseases (15%) in the ICP group than in the control group (4%) (p = 0.011). The number of underlying causes of death due to diseases of the circulatory system were lower in the ICP group (13%) than in the control group (26%), although the finding was not statistically significant (p = 0.088). Moreover, neoplasms were the underlying cause of death in 46% of cases among mothers with ICP and in 41% of cases among the controls (p = 0.609). Diseases of the other organ systems were rare in both groups.
Women with a history of ICP do not have an increased overall mortality. However, deaths from gastrointestinal diseases are overrepresented among women with a history of ICP.
本研究的目的是确定妊娠肝内胆汁淤积症（ICP）是否与分娩后平均35年随访期间的死亡原因有关。
研究人群包括1969年至1988年期间在芬兰坦佩雷大学医院至少有一次妊娠合并ICP的571名女性。通过患者记录核实ICP情况。将产科病房日记中前后的对象作为每个ICP病例的对照。总共有1333名对照。所有潜在死因均来自2017年3月的芬兰统计局。死亡发生在1971 - 2015年期间，死因根据国际疾病分类第十版（ICD - 10）进行分类。
到2015年底，共有39名患有ICP的母亲（6.8%）和111名对照（8.3%）死亡（p = 0.267）。ICP组胃肠道疾病导致的潜在死因（15%）多于对照组（4%）（p = 0.011）。ICP组循环系统疾病导致的潜在死因数量（13%）低于对照组（26%），尽管该结果无统计学意义（p = 0.088）。此外，肿瘤是46%的患有ICP的母亲死亡的潜在原因，对照组中这一比例为41%（p = 0.609）。两组中其他器官系统疾病均较少见。
有ICP病史的女性总体死亡率没有增加。然而，有ICP病史的女性中因胃肠道疾病死亡的比例过高。
