Predictors of premature delivery in patients with intrahepatic cholestasis of pregnancy
Predictors of premature delivery in patients with intrahepatic cholestasis of pregnancy
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DOI：
10.3748/wjg.13.6226
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发表时间：
2007-12-14
影响因子：
4.3
通讯作者：
Kupcinskas, Limas
中科院分区：
文献类型：
--
作者：
Kondrackiene, Jurate;Beuers, Ulrich;Kupcinskas, Limas
目的：目的：探讨妊娠期肝内胆汁淤积症（ICP）的临床症状和生化指标对早产的预测价值。早产定义为妊娠37周前分娩。早产的预测因素通过二元多变量logistic回归分析揭示。结果：平均分娩时间为38.1 ± 1.7周。未发生死胎。8例（13.3%）患者发生早产。与足月分娩患者相比，早产患者的总空腹血清胆汁酸较高（47.8 +/- 15.2 vs 41.0 +/- 10.0 μ mol/L，P < 0.05），瘙痒倾向于较早开始（29.0 +/- 3.9 vs 31.6 +/- 3.3 wk，P = 0.057）。二元多因素Logistic回归分析显示，瘙痒症的早期发作（OR 1.70，95% CI 1.23-2.95，P = 0.038）和血清胆汁酸（OR 2.13，95%CI 1.13-3.25，P = 0.013）是早产的独立预测因素。早发型瘙痒和高水平血清胆汁酸可预测ICP早产，并确定了一个新生儿预后不良的危险亚组。(c)2007年WJG。All rights reserved.
AIM: To evaluate the predictive value of clinical symptoms and biochemical parameters for prematurity in intrahepatic cholestasis of pregnancy (ICP).METHODS: Sixty symptomatic patients with ICP were included in this retrospective analysis. Preterm delivery was defined as delivery before 37 wk gestation. Predictors of preterm delivery were disclosed by binary multivariate logistic regression analysis.RESULTS: Mean time of delivery was 38.1 +/- 1.7 wk. No stillbirths occurred. Premature delivery was observed in eight (13.3%) patients. Total fasting serum bile acids were higher (47.8 +/- 15.2 vs 41.0 +/- 10.0 mu mol/L, P < 0.05), and pruritus tended to start earlier (29.0 +/- 3.9 vs 31.6 +/- 3.3 wk, P = 0.057) in patients with premature delivery when compared to those with term delivery. Binary multivariate logistic regression analysis revealed that early onset of pruritus (OR 1.70, 95% CI 1.23-2.95, P = 0.038) and serum bile acid (OR 2.13, 95% CI 1.13-3.25, P = 0.013) were independent predictors of preterm delivery.CONCLUSION: Early onset of pruritus and high levels of serum bile acids predict preterm delivery in ICP, and define a subgroup of patients at risk for poor neonatal outcome. (c) 2007 WJG. All rights reserved.