妊娠期肝内胆汁淤积症早产与自发性早产临床结局的对比分析

Comparative Analysis of Clinical Outcomes of Intrahepatic Cholestasis of Pregnancy and Spontaneous Preterm Delivery

目的:回顾性分析妊娠期肝内胆汁淤积症(ICP)早产儿与自发性早产儿的妊娠结局,探讨ICP对早产儿的影响。方法:分析2003年1月至2009年12月我院收治的1323例ICP患者,统计因ICP及其并发症而终止妊娠的早产儿(ICP早产组)的早产率、孕周、儿科住院情况、处理和结局,并与同期自发性早产280例(自发性早产组)进行围生儿结局对比分析。结果:1323例ICP孕妇,发生早产270例,早产率20.41%,其中双胎12例,分娩胎儿282个,经阴道分娩83例,剖宫产187例(69.26%)。与自发性早产组相比:剖宫产率、新生儿窒息率、高胆红素血症、新生儿肺炎、新生儿呼吸窘迫综合征发生率等差异均有统计学意义(P<0.05)。NICU住院时间及平均住院费用均较自发性早产组高(P<0.05)。结论:ICP早产和剖宫产密切相关,医源性提前终止妊娠是早产率增加的主要原因,ICP早产儿中并发症发生率较高。

Objective：Retrospective analysis of outcome of premature children between intrahepatic cholestasis of pregnancy（ICP） and spontaneous preterm delivery,and probe the impact of ICP on premature children.Methods：A retrospective analysis was conducted on 1323 cases of ICP admitted to Southwest Hospital from Jan 2003 to Dec 2009. The rate of preterm birth,gestational age,pediatric hospitalization,treatment and outcomes in preterm delivery because of ICP and its complications（ICP group） were analyzed. 280 cases of spontaneous preterm birth in the same period（control group） were compared in perinatal outcome.Results：In 1323 cases of ICP pregnant women,270 cases were preterm birth,the preterm delivery rate was 20.4%,of which 12 cases were twins. 282 fetuses were delivered,in which 83 cases were vaginal delivery and 187 cases were cesarean section（69.26%） . Compared with the control group：There was statistical different in cesarean section rate,neonatal asphyxia,hyperbilirubinemia,neonatal pneumonia,incidence of neonatal respiratory distress syndrome between two groups（P0.05） . Length of stay in NICU and average costs in ICP group was higher than control group.Conclusions：Preterm birth due to ICP is closely related to cesarean section,iatrogenic termination of pregnancy is mainly due to increased rates of preterm birth. The incidence of complications in premature children due to ICP is higher.