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妊娠期肝内胆汁淤积症对婴幼儿食物过敏的影响:一项中国西南地区的回顾性纵向研究队列

Effect of intrahepatic cholestasis of pregnancy on infantile food allergy: A retrospective longitudinal study cohort in Southwest China.

作者信息

Huang Liqiong, Li Xin, Liu Tianjiao, Wei Lu, Fan Conghong, Tang Dongmei, Xiong Wen, Li Yalan, Wei Sumei, Xiong Zhengai

机构信息

The Second Affiliated Hospital of Chongqing Medical University, Chongqing 610000, China; Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 611731, China.

Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 611731, China.

出版信息

Eur J Obstet Gynecol Reprod Biol. 2022 May;272:110-115. doi: 10.1016/j.ejogrb.2022.03.026. Epub 2022 Mar 14.

Abstract

INTRODUCTION

Intrahepatic cholestasis of pregnancy has been consistently associated with a higher incidence of adverse pregnancy outcomes. Previous studies mainly focused on the effects of intrahepatic cholestasis of pregnancy on pregnant mothers and fetuses, and few studies reported the postpartum growth and development of fetuses in pregnant women with intrahepatic cholestasis of pregnancy. The aim of this study was to investigate impact of maternal serum total bile acid levels on maternal and neonatal outcomes as well as child growth and food allergy.

MATERIAL AND METHODS

A retrospective longitudinal cohort investigation was carried out among 751 pregnant women with intrahepatic cholestasis of pregnancy at 30-32 weeks of gestation from the Longitudinal Intrahepatic Cholestasis of Pregnancy Study (LoICPS). Data on the characteristics of the mothers and neonates were collected. Infant growth data and food sensitivities were also collected.

RESULTS

In our cohort, the average maternal serum total bile acid level was 35.09±30.02 μmol/L, with 58.8% of mothers suffering from mild intrahepatic cholestasis of pregnancy and 29.2% suffering from severe intrahepatic cholestasis of pregnancy. Positive correlations were found between maternal serum total bile acid levels and twin pregnancy (beta-value: 11.55, 95% CI: 2.89 - 20.20. P = 0.009) and meconium stained amniotic fluid (beta-value: 14.64, 95% CI: 9.41 - 19.87. P < 0.001). In addition, the infants of mothers with severe intrahepatic cholestasis of pregnancy were more likely to be allergic to foods at 6 months.

CONCLUSIONS

This study suggested that despite pregnant women with intrahepatic cholestasis of pregnancy taking ursodeoxycholic acid tablets and cesarean section before expected date of childbirth, the perinatal outcome of newborns partially improving, the incidence of infantile food allergy was still increased.

摘要

引言

妊娠期肝内胆汁淤积症一直与不良妊娠结局的较高发生率相关。以往研究主要关注妊娠期肝内胆汁淤积症对孕妇和胎儿的影响,很少有研究报道妊娠期肝内胆汁淤积症孕妇产后胎儿的生长发育情况。本研究的目的是调查母体血清总胆汁酸水平对母婴结局以及儿童生长和食物过敏的影响。

材料与方法

对来自妊娠期肝内胆汁淤积症纵向研究(LoICPS)的751例妊娠30 - 32周的妊娠期肝内胆汁淤积症孕妇进行回顾性纵向队列研究。收集母亲和新生儿的特征数据。还收集了婴儿生长数据和食物敏感性数据。

结果

在我们的队列中,母体血清总胆汁酸平均水平为35.09±30.02μmol/L,58.8%的母亲患有轻度妊娠期肝内胆汁淤积症,29.2%的母亲患有重度妊娠期肝内胆汁淤积症。发现母体血清总胆汁酸水平与双胎妊娠(β值:11.55,95%CI:2.89 - 20.20,P = 0.009)和羊水胎粪污染(β值:14.64,95%CI:9.41 - 19.87,P < 0.001)呈正相关。此外,患有重度妊娠期肝内胆汁淤积症母亲的婴儿在6个月时更易对食物过敏。

结论

本研究表明,尽管妊娠期肝内胆汁淤积症孕妇服用了熊去氧胆酸片并提前剖宫产,新生儿围产期结局部分改善,但婴儿食物过敏的发生率仍有所增加。

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