Denızlı Ramazan, Sakcak Bedri, Farisoğulları Nihat, Peker Melis Ece Men, Sınacı Selcan, Kara Özgür, Tanacan Atakan, Tekın Özlem Moraloğlu, Şahın Dilek
Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, 06800 Turkey.
University of Health Sciences, Ankara City Hospital, Ankara, Turkey.
SN Compr Clin Med. 2022;4(1):184. doi: 10.1007/s42399-022-01267-1. Epub 2022 Aug 11.
This study aims to investigate the perinatal outcomes in COVID-19 pregnant women with intrahepatic cholestasis of pregnancy (ICP) and elevated liver enzymes. Present study was carried out on pregnant women with COVID-19 between March 11, 2020, and August 11, 2021. Patients with liver enzyme levels higher than twice the upper limit of the reference range for aspartate aminotransferase(AST) and/or alanine aminotransferase (ALT) were included. Patients with unexplained pruritus and elevated fasting biliary acid (FBA) levels were considered ICP. The remaining cases were used as the control group. There were a total of 1751 patients in the study period. Among them, 126 had elevated liver enzymes. Nineteen of these cases had also ICP. AST and ALT values were statistically higher in the ICP group. Demographic features, clinical characteristics, and perinatal outcomes were similar between the groups. The rate of ICP in pregnant women with COVID-19 was similar to the literature in this study. Although the preterm delivery rates for both groups were higher than in the current literature, the preterm delivery rates in the study and control groups were similar. Elevated liver enzymes can be observed in pregnant women with COVID-19 with higher rates of preterm delivery compared to the previous literature. However, the diagnosis of ICP in addition to elevated liver enzymes seems to have no significant impact on the perinatal outcomes. Future studies conducted on larger populations are necessary to confirm these results.
本研究旨在调查患有妊娠肝内胆汁淤积症（ICP）且肝酶升高的新型冠状病毒肺炎（COVID-19）孕妇的围产期结局。本研究于2020年3月11日至2021年8月11日对患有COVID-19的孕妇进行。纳入天冬氨酸转氨酶（AST）和/或丙氨酸转氨酶（ALT）水平高于参考范围上限两倍的患者。有不明原因瘙痒且空腹胆汁酸（FBA）水平升高的患者被视为ICP。其余病例作为对照组。研究期间共有175名患者。其中，126名患者肝酶升高。这些病例中有19名也患有ICP。ICP组的AST和ALT值在统计学上更高。两组之间的人口统计学特征、临床特征和围产期结局相似。本研究中COVID-19孕妇的ICP发生率与文献报道相似。虽然两组的早产率均高于当前文献，但研究组和对照组的早产率相似。与以往文献相比，患有COVID-19的孕妇肝酶升高且早产率更高。然而，除肝酶升高外，ICP的诊断似乎对围产期结局没有显著影响。有必要对更大规模人群进行进一步研究以证实这些结果。
