摘要
目的:分析单纯性妊娠期肝内胆汁淤积症对围产儿不良结局的影响。方法:以2009年06月01日至2010年12月31日在我院住院分娩的1 808名正常产妇与100名妊娠期肝内胆汁淤积产妇为研究对象,分析两组间围产儿不良结局差异。结果:ICP组产妇的剖宫产率(81.0%)高于对照组(57.9%);围生儿孕周(37.9周±1.5周)小于对照组(38.9周±1.5周);围生儿出生体重(3 270.1 g±525.7g)低于对照组(3376.7g±456.1g);围生儿羊水粪污发生率(28.0%)高于对照组(18.9%);围生儿重度窒息发生率(2.0%)高于对照组(0.3%),差异均有统计学意义(P值均小于0.05)。ICP产妇的血胆酸值与围生儿孕周呈负相关关系(r=-0.455,P=0.000),与早产呈正相关关系(r=0.298,P=0.003);与围生儿出生体重、羊水粪污及窒息发生均无相关关系(P值均大于0.05)。结论:单纯性ICP产妇剖宫产、早产、羊水污染、新生儿重度窒息发生率均较高,且胆酸值越高,早产几率越大,出生体重越低。
Objective：To analyze the impact of intrahepatic cholestasis of pregnancy（ICP） on adverse perinatal outcomes after excluding other pregnant complications.Methods：Women who delivered from June 1st,2009 to December 31th,2010 in maternal and child health care hospital in Hefei,Anhui Province were selected as participants,those with any psychological disorders being excluded.Socio—demographic data,clinical diagnosis information and delivery records were assessed by a structured questionnaire.A total of 100 ICP cases and 1 808 normal were identified. Differences of main adverse perinatal outcomes were compared by paired—samples t test,Chi square test and correlation analysis between the two groups.Results：There were no significant differences in socio-demographic information between ICP group and control group（P0.05 for all comparisons）.Also there were no significant difference of parity,fetal gender,premature rupture of membranes,postpartum hemorrhage between the two groups（P0.05 for all comparisons）.The rate of caesarean delivery was 81.0%in ICP group,higher than that in control group （57.9%）;gestational age（37.9w±1.5w） and birth weight in ICP group（3270.1g±525.7g） were both lower than that in control group（38.9w±1.5w,3 376.7g±456.1g）;the rate of amniotic fluid pollution（28.0%） and severe asphyxia（2.0%） were higher than that in control group （18.9%,0.3%）.These differences were all of statistical significance（P0.05 for all comparisons）.Correlation analysis for ICP groups manifested that the level of cholic acid negatively correlated with gestational age（r=-0.455,P=0.000）,and positively correlated with premature（r = 0.298,P=0.003 ）.Other outcomes were not found to be associated with the level of cholic acid（P0.05 for all comparisons）.Conclusions： After excluding other complications,ICP may have adverse effect on perinatal outcomes.Higher level the cholic acid is,greater risk of premature birth and lower birth weight may happen.
基金
安徽省卫生厅自筹经费项目(项目编号:09C183)
合肥市科技局应用技术研究与开发项目(项目编号:2008-1007)
