Obstetrical Department, Huzhou Maternal and Child Health Hospital, WuXing District, Huzhou City, Zhejiang Province, China.
PLoS One. 2024 Jun 4;19(6):e0304604. doi: 10.1371/journal.pone.0304604. eCollection 2024.
Intrahepatic cholestasis of pregnancy (ICP) is a serious liver conditions that negatively impacts obstetric and neonatal outcomes. Elevated levels of bile acid, particularly glycine conjugate, may compromise blood flow and cause functional hypoxia-ischemia.
This meta-analysis aims to assess the association between ICP and key pregnancy outcomes including emergency caesarian sections (C-sections), preeclampsia, hemorrhage, preterm birth, small for gestational age, admission rate to neonatal intensive care union (NICU), gestational age, and stillbirth.
Literature search across five databases (PubMed, Embase, Web of Science) was done to detect relevant studies published up until June 2023. Meta-analysis of the identified studies was done using a random-effects model, and the results presented as Odds ratio (OR).
A literature search identified 662 studies. Of them, 21 met the inclusion criteria. There was a significant association between ICP and odds of C-section (OR: 1.42, p <0.001), preeclampsia (OR: 2.64, p <0.001), NICU admission (OR: 2.1, p <0.001), and pre-term birth (OR: 2.64, p <0.001). ICP was not associated with postpartum hemmorhage (OR: 1.31, p = 0.13), small for gestational age (OR: 0.87, p = 0.07), stillbirth (OR: 1.49, p = 0.29).
Our results confirm the adverse effects of ICP on co-existing pregnancy complications, obstetric and neonatal outcomes. ICP in associated with severe complications including increased rates of preeclampsia, emergency C-sections, preterm births, l gestational periods and higher rates of NICU admissions. These results may assist healthcare professionals in formulating comprehensive care guidelines for expectant mothers and newborns.
妊娠肝内胆汁淤积症（ICP）是一种严重的肝脏疾病，会对产科和新生儿结局产生负面影响。胆汁酸水平升高，特别是甘氨酸结合物，可能会影响血流并导致功能缺氧-缺血。
本荟萃分析旨在评估 ICP 与关键妊娠结局的关系，包括紧急剖宫产（C -section）、子痫前期、出血、早产、小于胎龄儿、新生儿重症监护病房（NICU）入院率、胎龄和死产。
在五个数据库（PubMed、Embase、Web of Science）中进行文献检索，以检测截至 2023 年 6 月发表的相关研究。使用随机效应模型对确定的研究进行荟萃分析，并以比值比（OR）表示结果。
文献检索共确定了 662 项研究。其中，21 项符合纳入标准。ICP 与 C 剖宫率（OR：1.42，p <0.001）、子痫前期（OR：2.64，p <0.001）、NICU 入院率（OR：2.1，p <0.001）和早产（OR：2.64，p <0.001）显著相关。ICP 与产后出血（OR：1.31，p = 0.13）、小于胎龄儿（OR：0.87，p = 0.07）、死产（OR：1.49，p = 0.29）无关。
我们的研究结果证实了 ICP 对现有妊娠并发症、产科和新生儿结局的不良影响。ICP 与严重并发症相关，包括子痫前期、紧急 C 剖宫率、早产、胎龄缩短和 NICU 入院率增加等。这些结果可能有助于医疗保健专业人员为孕妇和新生儿制定全面的护理指南。
