妊娠期肝内胆汁淤积症对早产发生率的影响

Influence of intrahepatic cholestasis during pregnancy on the incidence of preterm birth ~

目的探讨妊娠期肝内胆汁淤积症（ICP）对早产发生率的影响。方法采用前瞻性队列研究，以2014年1月1日至2015年3月31日安庆市立医院所有住院分娩的单胎活产孕妇为研究对象。通过调查问卷和医院电子病历系统，收集孕妇人口学信息等资料，采用单因素和多因素统计方法分析ICP对早产发生率的影响。结果2758例孕妇ICP发生率为7．25％，早产发生率为16．28％。ICP增加早产和医源性早产的风险，分别为RR=2．33，95％CI：1．67～3．25和RR=8．46，95％CI：5．45～13．12，但对自发性早产的发生无影响（RR=O．94，95％CI：0．57～1．54）。结论ICP增加医源性早产的发生风险，与自发性早产的发生无明显相关。

Objective Intrahepatic cholestasis during pregnancy （ICP） and its relation to incidence of preterm birth （PTB） were under study. Methods A prospective cohort study was carried out that including all the hospitalized pregnant women with live singleton births, from January 2014 to March 2015 in Anqing Municipal Hospitals. Informed consent was followed in every pregnant woman with related demographic information collected through questionnaire and hospital electronic medical record system. Both univariate and multi-variate statistical methods were used to analyze the relations between ICP and incidence of PTB. Results A total of 2 758 pregnant women were included in this study. The incidence proportions of ICP and PTB appeared as 7.25% and 16.28% respectively. Results from the logistic regression analysis showed that ICP increased the risk of both overall PTB （RR= 2.33, 95%CI： 1.67-3.25） and medically indicated PTB （RR=8.46, 95%CI： 5.45-13.12）, but not the spontaneous PTB （RR=0.94, 95%CI： 0.57-1.54）. Conclusion ICP seemed to have increased the risk on medically indicated PTB but not the spontaneous PTB.