Depertmant of Obstetrics and Gynecology, Erciyes University Medicine Faculty, Kayseri, Turkey.
Department of Obstetrics and Gynecology, Kayseri City Hospital, Kayseri, Turkey.
J Perinat Med. 2021 Jul 20;50(1):87-92. doi: 10.1515/jpm-2021-0003. Print 2022 Jan 27.
Considering the effects of bile-acid levels on fetal lungs and pulmonary surfactants, we hypothesized that in the presence of intrahepatic pregnancy cholestasis (ICP), poor neonatal respiratory problems are observed in relation to the severity of the disease. Delivery timing with the presence of ICP is scheduled during late-preterm and early term gestational weeks. The aim of this study was to assess ICP and disease severity effects on transient tachypnea of the newborn (TTN) in uncomplicated fetuses.
This study comprised 1,097 singleton pregnant women who were separated into three groups-control, mild ICP, and severe ICP. The pregnant women diagnosed with ICP between January 2010 and September 2020 was investigated using the hospital's database. For the control group, healthy pregnant women who met the same exclusion criteria and were similar in terms of maternal age, gestational age at delivery, and mode of delivery were analyzed.
The TTN rate was 14.5% in the severe ICP group, 6.5% in the mild ICP group, and 6.2% in the control group. The TTN rate in the severe ICP group was significantly higher than that in the other groups (p<0.001). Similarly, the rate of admission to the neonatal intensive care unit was significantly higher in the severe ICP group than in the other groups (p<0.001). According to Pearson correlation analyses, maternal serum bile-acid levels were positively correlated with TTN (r=0.082; p=0.002).
Severe ICP, but not mild ICP, and serum bile-acid levels were positively correlated with increased TTN risk and reduced pulmonary surfactant levels.
考虑到胆汁酸水平对胎儿肺部和肺表面活性剂的影响，我们假设在存在肝内妊娠胆汁淤积症（ICP）的情况下，与疾病的严重程度相关，新生儿会出现较差的呼吸问题。伴有 ICP 的分娩时间计划在晚期早产和早期足月妊娠周进行。本研究旨在评估 ICP 和疾病严重程度对无并发症胎儿新生儿暂时性呼吸急促（TTN）的影响。
本研究纳入了 1097 名单胎孕妇，将其分为三组-对照组、轻度 ICP 组和重度 ICP 组。对 2010 年 1 月至 2020 年 9 月期间在医院数据库中诊断为 ICP 的孕妇进行了调查。对于对照组，分析了符合相同排除标准且在母亲年龄、分娩时的孕龄和分娩方式方面相似的健康孕妇。
重度 ICP 组 TTN 发生率为 14.5%，轻度 ICP 组为 6.5%，对照组为 6.2%。重度 ICP 组的 TTN 发生率明显高于其他组（p<0.001）。同样，重度 ICP 组新生儿重症监护病房的入住率明显高于其他组（p<0.001）。根据 Pearson 相关分析，母体血清胆汁酸水平与 TTN 呈正相关（r=0.082；p=0.002）。
重度 ICP 但不是轻度 ICP 以及血清胆汁酸水平与 TTN 风险增加和肺表面活性剂水平降低呈正相关。
