妊娠期肝内胆汁淤积症及其相关的孕产妇和胎儿不良结局：一项回顾性病例对照研究
Intrahepatic Cholestasis of Pregnancy and Associated Adverse Maternal and Fetal Outcomes: A Retrospective Case-Control Study.
作者信息
Luo Mingjuan, Tang Mengyang, Jiang Feng, Jia Yizhen, Chin Robert Kien Howe, Liang Wei, Cheng Hu
机构信息
The Third School of Clinical Medicine, Southern Medical University, Guangzhou, 510000 Guangdong, China.
Department of Endocrinology and Metabolism, Fengxian Central Hospital Affiliated to the Southern Medical University, Shanghai 201499, China.
出版信息
Gastroenterol Res Pract. 2021 Mar 25;2021:6641023. doi: 10.1155/2021/6641023. eCollection 2021.
OBJECTIVE
Intrahepatic cholestasis of pregnancy (ICP) is a common pregnancy-related liver disease and is associated with an increased risk of adverse neonatal outcomes. Ursodeoxycholic acid (UDCA) is the most effective treatment. This study was aimed at investigating the adverse outcomes of ICP and evaluating the effects of treatment with UDCA in patients with ICP.
METHODS
We included 114 women with ICP and 3725 women without ICP (no-ICP group) who delivered in our hospital between September 2017 and August 2019. The prevalence of ICP in this study was 3.15%. We matched each woman with ICP to five controls. Of all the 114 women with ICP, 73 (64.04%) received UDCA while 41 (35.96%) did not. Logistic multivariate regression analysis was used to compare the adverse outcomes between those with ICP and matched controls as well as between those who received UDCA (UDCA group) and those who did not (non-UDCA group).
RESULTS
Compared with controls, women with ICP were more likely to have preeclampsia (adjusted odds ratio, aOR = 16.74, 95% CI 5.29-52.98), cesarean section (aOR = 1.76, 95% CI 1.10-2.81), and preterm birth (aOR = 24.35, 95% CI 2.74-216.67). Administration of UDCA reduced the rate of preterm birth (1.37% vs. 14.63%, aOR = 0.10, 95% CI 0.01-0.90).
CONCLUSION
ICP increased the risk of preeclampsia, cesarean section, and preterm birth. UDCA could reduce the rate of preterm birth.
目的
妊娠期肝内胆汁淤积症（ICP）是一种常见的妊娠相关肝病，与不良新生儿结局风险增加有关。熊去氧胆酸（UDCA）是最有效的治疗方法。本研究旨在调查ICP的不良结局，并评估UDCA治疗ICP患者的效果。
方法
我们纳入了2017年9月至2019年8月在我院分娩的114例ICP女性和3725例无ICP女性（非ICP组）。本研究中ICP的患病率为3.15%。我们将每例ICP女性与五名对照进行匹配。在所有114例ICP女性中，73例（64.04%）接受了UDCA治疗，41例（35.96%）未接受治疗。采用多因素logistic回归分析比较ICP患者与匹配对照之间以及接受UDCA治疗者（UDCA组）与未接受治疗者（非UDCA组）之间的不良结局。
结果
与对照组相比，ICP女性更易发生子痫前期（校正比值比，aOR = 16.74，95%CI 5.29 - 52.98）、剖宫产（aOR = 1.76，95%CI 1.10 - 2.81）和早产（aOR = 24.35，95%CI 2.74 - 216.67）。给予UDCA可降低早产率（1.37%对14.63%，aOR = 0.10，95%CI 0.01 - 0.90）。
结论
ICP增加了子痫前期、剖宫产和早产的风险。UDCA可降低早产率。
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