Department of Obstetrics and Gynecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
Department of Obstetrics and Gynecology, Yubei District Maternal and Child Health Hospital, Chongqing, China.
Sci Rep. 2024 May 28;14(1):12185. doi: 10.1038/s41598-024-63183-9.
Intrahepatic cholestasis of pregnancy (ICP) can lead to many adverse pregnancy outcomes, and the influencing factors remain unclear at present. This study retrospectively analyzed clinical data from 1815 pregnant women with ICP and evaluated the relationship between ICP subtypes, gestational age at onset, and pregnancy outcomes. The results of this study show that during pregnancy, the levels of biochemical indicators (TBA, DBIL and ALT) in the serum of pregnant women initially diagnosed with subtypes of ICP were noted to constantly change, and the subtype of ICP and its severity also changed. The incidence of adverse pregnancy outcomes [meconium-stained amniotic fluid (MSAF), NICU transfer, Apgar score ≤ 7 at 1 min, and preterm birth] in patients with ICP1 (icteric type) was significantly higher than for patients with ICP2, ICP3 or ICP4. The preterm birth rate of early-onset ICP was higher than that of late-onset ICP in ICP1 and ICP3 subtypes. In conclusion, the outcome of pregnancy in women with ICP is closely related to the serum TBA level and ICP subtype, which should be recognized in the clinic.
妊娠期肝内胆汁淤积症（ICP）可导致多种不良妊娠结局，其影响因素目前尚不清楚。本研究回顾性分析了 1815 例 ICP 孕妇的临床资料，评估了 ICP 亚型、发病孕周与妊娠结局的关系。结果显示，ICP 孕妇在妊娠期间，血清生化指标（TBA、DBIL 和 ALT）的初始诊断亚型不断变化，且 ICP 亚型及其严重程度也随之改变。ICP1（黄疸型）患者不良妊娠结局（羊水粪染、NICU 转科、1 分钟 Apgar 评分≤7 分、早产）的发生率显著高于 ICP2、ICP3 或 ICP4 患者。ICP1 和 ICP3 亚型中早发型 ICP 的早产率高于晚发型 ICP。综上所述，ICP 孕妇的妊娠结局与血清 TBA 水平和 ICP 亚型密切相关，临床应予以重视。
