Intrahepatic Cholestasis of Pregnancy and Associated Hepatobiliary Disease: A Population-Based Cohort Study
Intrahepatic Cholestasis of Pregnancy and Associated Hepatobiliary Disease: A Population-Based Cohort Study
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DOI：
10.1002/hep.26444
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发表时间：
2013-10-01
期刊：
影响因子：
13.5
通讯作者：
Stephansson, Olof
中科院分区：
文献类型：
--
作者：
Marschall, Hanns-Ulrich;Shemer, Elisabeth Wikstrom;Stephansson, Olof
妊娠期肝内胆汁淤积症是妊娠期最常见的肝病。我们的目的是评估患有妊娠肝内胆汁淤积症的妇女发生肝胆疾病的风险，以及患有常见肝胆疾病的妇女发生妊娠肝内胆汁淤积症的几率。我们分析了1973年至2009年在瑞典医学出生登记处登记的生育妇女的数据。通过与瑞典患者登记处的联系，我们确定了11,388名患有ICP的妇女与113,893名没有这种诊断的妇女相匹配。先前存在或后来存在的肝胆疾病的诊断从患者名册中获得。主要观察指标为：在患有妊娠肝内胆汁淤积症的妇女中，发生晚期肝胆疾病的危险比(HRs)和在既往存在的肝胆疾病中发生肝内胆汁淤积症的优势比(ORs)。风险估计通过COX和Logistic回归分析计算。妊娠肝内胆汁淤积症(HR 2.62；95%可信区间[CI]2.47-2.77；每年递增1%)、丙型肝炎或慢性肝炎(HR分别为4.16；3.14-5.51和5.96；3.43-10.33)、纤维化/肝硬变(HR 5.11；3.29-7.96)、胆石病或胆管炎(HR 2.72；2.55-2.91和4.22；分别为3.13~5.69)，与非妊娠肝内胆汁淤积症患者比较，差异有统计学意义(P
Intrahepatic cholestasis of pregnancy (ICP) is the most common liver disease in pregnancy. We aimed to estimate the risk of developing hepatobiliary disease in women with ICP and the odds of developing ICP in women with prevalent hepatobiliary disease. We analyzed data of women with births between 1973 and 2009 and registered in the Swedish Medical Birth Register. By linkage with the Swedish Patient Register, we identified 11,388 women with ICP who were matched to 113,893 women without this diagnosis. Diagnoses of preexisting or later hepatobiliary disease were obtained from the Patient Register. Main outcome measures were hazard ratios (HRs) for later hepatobiliary disease in women with ICP and odds ratios (ORs) for developing ICP in preexisting hepatobiliary disease. Risk estimates were calculated through Cox and logistic regression analyses. Women with ICP were more often diagnosed with later hepatobiliary disease (HR 2.62; 95% confidence interval [CI] 2.47-2.77; increment at 1% per year), hepatitis C or chronic hepatitis (HR 4.16; 3.14-5.51 and 5.96; 3.43-10.33, respectively), fibrosis/cirrhosis (HR 5.11; 3.29-7.96), gallstone disease or cholangitis (HR 2.72; 2.55-2.91, and 4.22; 3.13-5.69, respectively) as compared to women without ICP (P