Purpose

To evaluate maternal and neonatal outcomes in patients with intrahepatic cholestasis of pregnancy (ICP).

Methods

Patients who gave birth in our hospital between January 2018 and March 2022 were retrospectively reviewed from the hospital database and patient file records. The study comprised 1686 patients, 54 in the ICP group and 1632 controls. Patients who had ICP after 20 weeks of gestation and were monitored and delivered at our facility were enrolled. Maternal demographic and obstetric characteristics data were examined. Perinatal outcomes were also assessed. Logistic regression analysis was used to determine adverse maternal outcomes.

Results

The mean age was 29 years. ART, GDM, and preeclampsia were significantly higher in the ICP group. The mean serum bile acid level was 19.3 ± 3 μmol/L in the ICP group. There was a higher risk of GDM and pre-eclampsia in women with ICP compared with those without and a significant association between ICP and adverse perinatal outcomes. There was a statistically significant relation between the presence of ICP and spontaneous preterm delivery, iatrogenic preterm delivery, 5th-minute Apgar scores < 7, and NICU requirement. No significant relationship was found between the presence of ICP and SGA and meconium. There was a significant relationship between the presence of ICP, mode of delivery, and PPH (p < 0.05). Those with ICP had a lower gestational week and birth weight, and higher rates of cesarean delivery and PPH.

Conclusion

ICP should prompt close monitoring and management to mitigate the potential exacerbation of adverse outcomes, including preeclampsia, GDM, and preterm birth.

中文翻译：

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妊娠期肝内胆汁淤积及其与先兆子痫和妊娠期糖尿病的关系：回顾性分析

目的

评估妊娠期肝内胆汁淤积 (ICP) 患者的孕产妇和新生儿结局。

方法

通过医院数据库和患者档案记录，对2018年1月至2022年3月期间在我院分娩的患者进行回顾性分析。该研究包括 1686 名患者，其中 54 名 ICP 组和 1632 名对照组。妊娠 20 周后患有 ICP 并在我们的机构进行监测和分娩的患者被纳入。检查了母亲人口统计和产科特征数据。还评估了围产期结局。使用逻辑回归分析来确定不良的产妇结局。

结果

平均年龄为 29 岁。 ICP 组中 ART、GDM 和先兆子痫的发生率显着较高。 ICP组的平均血清胆汁酸水平为19.3±3μmol/L。与没有 ICP 的女性相比，患有 ICP 的女性患 GDM 和先兆子痫的风险更高，并且 ICP 与不良围产期结局之间存在显着关联。 ICP 的存在与自发性早产、医源性早产、第 5 分钟 Apgar 评分 < 7 和 NICU 需求之间存在统计学显着关系。 ICP 和 SGA 的存在与胎便之间没有发现显着关系。 ICP 的存在、分娩方式和 PPH 之间存在显着关系 (p < 0.05)。 ICP 患者的孕周和出生体重较低，剖宫产率和 PPH 率较高。

结论

ICP 应促进密切监测和管理，以减轻不良后果的潜在恶化，包括先兆子痫、妊娠期糖尿病和早产。