Mohan Manoj, Prabhu Sanjay Swargathmadhom, Pullattayil Abdul Kareem, Lindow Stephen
Department of Obstetrics and Gynecology, Aster DM Healthcare, Doha, Qatar (Dr Mohan).
Department of Obstetrics and Gynecology, Sidra Medicine, Doha, Qatar (Dr Prabhu).
AJOG Glob Rep. 2021 Jun 14;1(3):100013. doi: 10.1016/j.xagr.2021.100013. eCollection 2021 Aug.
Gestational diabetes and obstetrical cholestasis are common clinical conditions seen in clinical practice. There is evidence suggesting a coexisting relationship that could have a potential clinical implication related to stillbirth outcomes.
This study aimed to determine the prevalence of gestational diabetes in women with obstetrical cholestasis.
A predefined protocol with a literature search was used to obtain all possible articles. A systematic review and meta-analysis of observational studies with quantifiable data published since 2010 were performed. Articles were evaluated and included in the study with specified criteria for the risk of bias using the Newcastle-Ottawa Scale. A meta-analysis was performed using Meta-analysis of Observational Studies in Epidemiology specifications to determine the prevalence of gestational diabetes in women with obstetrical cholestasis.
A total of 16,748 patients with obstetrical cholestasis from 21 studies were included. The prevalence of gestational diabetes in women with obstetrical cholestasis was 13.9% (20 studies analyzed). Gestational diabetes was more common in women with obstetrical cholestasis than in women without obstetrical cholestasis (odds ratio, 2.129; 95% confidence interval, 1.697-2.670;10 studies). Gestational diabetes is twice more common in women with severe cholestasis than in women with mild cholestasis (odds ratio, 2.168; 95% confidence interval, 1.429-3.289; 4 studies).
There is an increase in the prevalence of gestational diabetes among women diagnosed with obstetrical cholestasis. Compared with women with mild cholestasis, the increased risk of gestational diabetes in women with severe cholestatis is more than doubled. This suggests that the 2 conditions may have some biological similarities that affect clinical outcomes.
妊娠期糖尿病和产科胆汁淤积症是临床实践中常见的临床病症。有证据表明两者存在共存关系，这可能对死产结局具有潜在的临床意义。
本研究旨在确定产科胆汁淤积症女性中妊娠期糖尿病的患病率。
采用预定义方案并进行文献检索以获取所有可能的文章。对2010年以来发表的具有可量化数据的观察性研究进行系统评价和荟萃分析。使用纽卡斯尔-渥太华量表根据特定的偏倚风险标准对文章进行评估并纳入研究。采用流行病学观察性研究荟萃分析规范进行荟萃分析，以确定产科胆汁淤积症女性中妊娠期糖尿病的患病率。
共纳入21项研究中的16748例产科胆汁淤积症患者。产科胆汁淤积症女性中妊娠期糖尿病的患病率为13.9%（分析了20项研究）。产科胆汁淤积症女性患妊娠期糖尿病比无产科胆汁淤积症的女性更常见（优势比，2.129；95%置信区间，1.697 - 2.670；10项研究）。重度胆汁淤积症女性患妊娠期糖尿病的几率是轻度胆汁淤积症女性的两倍多（优势比，2.168；95%置信区间，1.429 - 3.289；4项研究）。
被诊断为产科胆汁淤积症的女性中妊娠期糖尿病的患病率有所增加。与轻度胆汁淤积症女性相比，重度胆汁淤积症女性患妊娠期糖尿病的风险增加了一倍多。这表明这两种病症可能存在一些影响临床结局的生物学相似性。
