Fetal outcomes in pregnancies complicated by intrahepatic cholestasis of pregnancy in a Northern California cohort.
Fetal outcomes in pregnancies complicated by intrahepatic cholestasis of pregnancy in a Northern California cohort.
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DOI：
10.1371/journal.pone.0028343
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发表时间：
2012
期刊：
影响因子：
3.7
通讯作者：
Bull L
中科院分区：
文献类型：
--
作者：
Rook M;Vargas J;Caughey A;Bacchetti P;Rosenthal P;Bull L
妊娠肝内胆汁淤积症（ICP）具有重要的胎儿意义。不良胎儿结局的风险增加，包括早产、羊水胎粪染色、呼吸窘迫、胎儿窘迫和死亡。2005年1月至2009年3月在旧金山总医院诊断为ICP的101名妇女被纳入本研究。采用单因素logistic回归模型评估母体临床和生化指标与胎儿并发症的关系。分析的临床预测因素包括年龄、种族/民族、妊娠、胎次、肝脏或胆道疾病史、既往妊娠ICP史和引产。生化预测指标包括血清天冬氨酸转氨酶、丙氨酸转氨酶、碱性磷酸酶、总胆红素、直接胆红素、白蛋白、总蛋白和总胆汁酸（TBA）。ICP患病率为1.9%。大多数是拉丁裔（90%）。大多数分娩是引产（87%），大多数是自然阴道分娩（84%）。33%的分娩发生胎儿并发症，呼吸窘迫占大多数并发症。没有统计学意义的临床或生化预测因素与胎儿并发症风险增加相关。TBA升高与胎儿并发症的关系不大，直到TBA高于100µmoL/L， 5例中有3例出现并发症。既往妊娠ICP与胎儿并发症风险降低相关（OR 0.21, p = 0.046）。无晚期胎儿死亡病例。产妇的临床和实验室特征，包括TBA升高，似乎并不是ICP胎儿并发症的重要预测因素。
Intrahepatic cholestasis of pregnancy (ICP) has important fetal implications. There is increased risk for poor fetal outcomes, including preterm delivery, meconium staining of amniotic fluid, respiratory distress, fetal distress and demise. One hundred and one women diagnosed with ICP between January 2005 and March 2009 at San Francisco General Hospital were included in this study. Single predictor logistic regression models were used to assess the associations of maternal clinical and biochemical predictors with fetal complications. Clinical predictors analyzed included age, race/ethnicity, gravidity, parity, history of liver or biliary disease, history of ICP in previous pregnancies, and induction. Biochemical predictors analyzed included serum aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, total bilirubin, direct bilirubin, albumin, total protein, and total bile acids (TBA). The prevalence of ICP was 1.9%. Most were Latina (90%). Labor was induced in the majority (87%) and most were delivered by normal spontaneous vaginal delivery (84%). Fetal complications occurred in 33% of the deliveries, with respiratory distress accounting for the majority of complications. There were no statistically significant clinical or biochemical predictors associated with an increased risk of fetal complications. Elevated TBA had little association with fetal complications until reaching greater than 100 µmoL/L, with 3 out of 5 having reported complications. ICP in previous pregnancies was associated with decreased risk of fetal complications (OR 0.21, p = 0.046). There were no cases of late term fetal demise. Maternal clinical and laboratory features, including elevated TBA, did not appear to be substantial predictors of fetal complications in ICP.
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影响因子：
7.2
作者：
Oyelese, Yinka;Culin, Angelina;Smulian, John C.
通讯作者：
Smulian, John C.
影响因子：
13.5
作者：
Glantz, A;Marschall, HW;Mattsson, LÅ
通讯作者：
Mattsson, LÅ
影响因子：
4.3
作者：
Kondrackiene, Jurate;Beuers, Ulrich;Kupcinskas, Limas
通讯作者：
Kupcinskas, Limas
DOI：
10.1080/714052719
发表时间：
2001-04-01
期刊：
The Journal of maternal-fetal medicine
影响因子：
--
作者：
Laifer, S A;Stiller, R J;Whetham, J C
通讯作者：
Whetham, J C
影响因子：
13.5
作者：
Paumgartner, G;Beuers, U
通讯作者：
Beuers, U