Clinical Data Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.
School of Pediatrics, Guangzhou Medical University, Guangzhou, China.
BMC Pregnancy Childbirth. 2024 Jul 12;24(1):476. doi: 10.1186/s12884-024-06645-2.
What kinds of fetal adverse outcomes beyond stillbirth directly correlate to the severity of intrahepatic cholestasis during pregnancy (ICP) remained tangled. Herein, we conducted a retrospective cohort study and a dose-response meta-analysis to speculate the association between the severity of ICP and its adverse outcomes.
We retrospectively collected a cohort of ICP patients from electronic records from Guangzhou Women and Children's Medical Center between Jan 1st, 2018, and Dec 31st, 2022. Also, we searched PubMed, Cochrane, Embase, Scopus, and Web of Science to extract prior studies for meta-analysis. The Kruskal-Wallis test, a one-way or two-way variants analysis (ANOVA), and multi-variant regression are utilized for cohort study. One stage model, restricted cubic spline analysis, and fixed-effect model are applied for dose-response meta-analysis. The data analysis was performed using the R programme.
Our cohort included 1,289 pregnant individuals, including 385 mild ICP cases, 601 low moderate ICP cases, 282 high moderate ICP cases, and 21 severe ICP cases. The high moderate bile acid levels were correlated to preterm birth [RR = 2.14, 95%CI 1.27 to 3.62), P < 0.01], and preterm premature rupture of membranes [RR = 0.34, 95%CI 0.19 to 0.62), P < 0.01]. We added our cases to cases reported by other studies included in the meta-analysis. There were 15,826 patients included in dose-response meta-analysis. The severity of ICP was associated with increased risks of stillbirth, spontaneous preterm birth, iatrogenic preterm birth, preterm birth, admission to neonatal intensive care unit, and meconium-stained fluid (P < 0.05).
Our study shows the correlation between the severity of ICP and the ascending risks of stillbirth, preterm birth, and meconium-stained fluid, providing new threshold TBA levels.
CRD42023472634.
除了死产之外，哪些胎儿不良结局与妊娠期间肝内胆汁淤积症（ICP）的严重程度直接相关仍存在争议。在此，我们进行了一项回顾性队列研究和剂量-反应荟萃分析，以推测 ICP 严重程度与其不良结局之间的关联。
我们从 2018 年 1 月 1 日至 2022 年 12 月 31 日，从广州妇女儿童医疗中心的电子病历中回顾性地收集了 ICP 患者队列。此外，我们还检索了 PubMed、Cochrane、Embase、Scopus 和 Web of Science，以提取荟萃分析的先前研究。队列研究采用 Kruskal-Wallis 检验、单向或双向方差分析（ANOVA）和多变量回归。剂量-反应荟萃分析采用单阶段模型、受限立方样条分析和固定效应模型。数据分析使用 R 程序进行。
我们的队列包括 1289 名孕妇，其中轻度 ICP 病例 385 例，低中度 ICP 病例 601 例，中重度 ICP 病例 282 例，重度 ICP 病例 21 例。高胆汁酸水平与早产相关[RR=2.14，95%CI 1.27 至 3.62），P<0.01]，和早产胎膜早破[RR=0.34，95%CI 0.19 至 0.62），P<0.01]。我们将自己的病例添加到荟萃分析中报告的其他研究的病例中。剂量-反应荟萃分析共纳入 15826 例患者。ICP 的严重程度与死产、自发性早产、医源性早产、早产、新生儿重症监护病房入院和胎粪污染羊水的风险增加相关（P<0.05）。
我们的研究表明，ICP 的严重程度与死产、早产和胎粪污染羊水的风险增加相关，为新的 TBA 水平提供了阈值。
CRD42023472634。
