摘要
目的:分析妊娠期肝内胆汁淤积症发生的危险因素及对妊娠结局的影响。方法:将2019年6月至2021年6月无锡市妇幼保健院接收的91例妊娠期肝内胆汁淤积症孕妇作为观察组,将同期来院进行正常产检的孕妇120例作为对照组。回顾性分析两组孕妇临床资料,并对妊娠期肝内胆汁淤积症发生的危险因素进行单因素、多因素logistic回归分析,并比较妊娠结局。结果:观察组存在妊娠期肝内胆汁淤积症家族史比例、乙肝病毒感染比例、双胎及以上比例、尿蛋白阳性比例、妊娠期高血压比例、妊娠期糖尿病比例、高雌激素比例、自身免疫性疾病比例、低硒摄入、低锌摄入比例均高于对照组,且除白蛋白(albumin,ALB)外,其余肝肾功能指标均高于对照组,差异有统计学意义(均P<0.05)。经多因素logistic回归分析,妊娠期肝内胆汁淤积症家族史、乙肝病毒感染、双胎及以上、尿蛋白阳性、妊娠期高血压、高雌激素、自身免疫性疾病、低硒摄入是影响妊娠期肝内胆汁淤积症发生的危险因素(均P<0.05)。观察组早产、胎膜早破、产后出血发生率均高于对照组(均P<0.05)。观察组宫内窘迫、羊水污染、低体重儿发生率均高于对照组,新生儿5 min Apgar评分低于对照组(均P<0.05)。结论:妊娠期肝内胆汁淤积症发生的危险因素为存在妊娠期肝内胆汁淤积症家族史、乙肝病毒感染、双胎及以上、尿蛋白阳性、妊娠期高血压、高雌激素、自身免疫性疾病、低硒摄入,这些因素会造成孕产妇围生期并发症增加,从而影响围生儿结局。
Objective:To analyze the risk factors of intrahepatic cholestasis of pregnancy and its influence on pregnancy outcome.Methods:A total of 91 pregnant women with intrahepatic cholestasis of pregnancy admitted to Wuxi Maternal and Child Health Hospital from June 2019 to June 2021 were selected as an observation group,and 120 pregnant women who came to our hospital for normal obstetric examination during the same period were selected as a control group.The clinical data of the 2 groups of pregnant women were retrospectively analyzed,and the risk factors for intrahepatic cholestasis of pregnancy were analyzed by univariate and multivariate logistic regression analysis,and the favorable pregnancy outcomes were compared.Results:The proportion of family history of intrahepatic cholestasis of pregnancy, the proportion of hepatitis B virus infection, the proportion of twins and above, the proportion of positive urine protein, the proportion of hypertension in pregnancy, the proportion of diabetes in pregnancy, the proportion of high estrogen, the proportion of autoimmune diseases, and the proportion of low selenium intake and low zinc intake in the observation group were higher than those in the control group, and except for albumin, the indexes of liver and kidney function were higher than those in the control group, and the differences were statistically significant (all P<0.05). Multivariate logistic regression analysis showed that family history of intrahepatic cholestasis of pregnancy, hepatitis B virus infection, twins and above, positive urine protein, gestational hypertension, high estrogen, autoimmune disease, and low selenium intake were the risk factors for intrahepatic cholestasis of pregnancy (all P<0.05). The incidences of premature birth, premature rupture of membranes, and postpartum hemorrhage in the observation group were higher than those in the control group (all P<0.05). The incidences of intrauterine distress, amniotic fluid pollution, and low birth weight infants in the observation group were higher than those in the control group, and the 5 min Apgar score of the neonates was lower than that in the control group (all P<0.05). Conclusion: The risk factors of intrahepatic cholestasis of pregnancy are family history of intrahepatic cholestasis of pregnancy, hepatitis B virus infection, twins and above, positive urine protein, gestational hypertension, high estrogen, autoimmune diseases, and low intake of selenium, which will increase maternal perinatal complications and affect perinatal outcomes.
作者
张静
孟璐
刘辰
张莹
ZHANG Jing;MENG Lu;LIU Chen;ZHANG Ying(Department of Obstetrics,Wuxi Maternal and Child Health Hospital,Wuxi Jiangsu 214000,China)
出处
《临床与病理杂志》
CAS
2022年第8期1868-1874,共7页
Journal of Clinical and Pathological Research
关键词
妊娠期肝内胆汁淤积症
危险因素
并发症
妊娠结局
intrahepatic cholestasis of pregnancy
risk factors
complications
pregnancy outcome