Department of General Practice, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
Janakkala Health Center, Turenki, Finland.
Acta Obstet Gynecol Scand. 2019 Dec;98(12):1534-1539. doi: 10.1111/aogs.13695. Epub 2019 Aug 14.
Intrahepatic cholestasis of pregnancy (ICP) is a reversible liver disorder occurring during pregnancy. It has a typical genetic background with known genetic mutations and can be considered an expression of this genetic predisposition. The objective of this study was to determine whether ICP is associated with specific long-term comorbidity.
The study population comprised 571 women with ICP in at least one pregnancy who were compared with 1333 pregnant women without ICP during 1969-1988 at Tampere University Hospital, Finland. The cohort's follow-up time was 44 years. All ICD-10 classification discharge diagnoses were examined for the women in the ICP group from 1998 to 2013 and ICD-10 diagnoses from outpatient care from 1969 to 2013.
At least one disease of the digestive system had been diagnosed in 50.4% (288/571) of the ICP mothers compared with 34.4% (459/1333) of the reference group (P < 0.001). In a more detailed analysis, women with a history of ICP had an increased risk for cholelithiasis and/or cholecystitis (odds ratio [OR] 2.88, 95% confidence interval [CI] 2.17 to 3.84), diseases of the pancreas (OR 2.26, 95% CI 1.20 to 4.27) and hypothyroidism (OR 2.38, 95% CI 1.27 to 4.46) compared with the reference group. Arterial diseases were less common in the ICP mothers than in the reference group (OR 0.38, 95% CI .15 to .99). Regarding other diseases, there were no statistically significant differences between the ICP mothers and reference group.
Half of the women with a history of ICP were diagnosed with at least one disease of the digestive system compared with a third in the reference group. The risk of cholelithiasis, cholecystitis, diseases of the pancreas and hypothyroidism was increased compared with the reference group. These are important facts when counseling women after a pregnancy with ICP. Also, this is of importance for the general practitioners and other physicians who take care of these women.
妊娠肝内胆汁淤积症（ICP）是一种发生于妊娠期间的可逆转的肝脏疾病。它具有典型的遗传背景，存在已知的基因突变，可被视为这种遗传易感性的一种表现。本研究旨在确定 ICP 是否与特定的长期合并症相关。
研究人群包括 1969 年至 1988 年期间在芬兰坦佩雷大学医院分娩的至少有一次 ICP 病史的 571 名妇女，并与 1333 名无 ICP 病史的孕妇进行了比较。该队列的随访时间为 44 年。对 ICP 组的所有女性进行了 1998 年至 2013 年的 ICD-10 分类出院诊断检查，并对 1969 年至 2013 年的门诊就诊进行了 ICD-10 诊断检查。
与对照组（459/1333，34.4%）相比，至少有一种消化系统疾病被诊断为 50.4%（288/571）的 ICP 母亲（P <0.001）。在更详细的分析中，有 ICP 病史的女性患胆石症和/或胆囊炎的风险增加（比值比 [OR] 2.88，95%置信区间 [CI] 2.17 至 3.84）、胰腺疾病（OR 2.26，95% CI 1.20 至 4.27）和甲状腺功能减退症（OR 2.38，95% CI 1.27 至 4.46）的风险高于对照组。与对照组相比，动脉疾病在 ICP 母亲中较少见（OR 0.38，95% CI 0.15 至 0.99）。至于其他疾病，ICP 母亲与对照组之间没有统计学上的显著差异。
与对照组的三分之一相比，有 ICP 病史的女性中，有一半至少被诊断出一种消化系统疾病。与对照组相比，胆石症、胆囊炎、胰腺疾病和甲状腺功能减退症的风险增加。这些都是对患有 ICP 妊娠的女性进行咨询时的重要事实。此外，这对于照顾这些女性的全科医生和其他医生也很重要。
