PDF(Pubmed)
Abstract：
BACKGROUND: Intrahepatic cholestasis of pregnancy (ICP) is associated with an increased risk of adverse fetal outcomes, yet its influence on offspring growth remains unclear. Our study dynamically tracks growth rates in children from ICP and healthy mothers and investigates the link between maternal liver function and developmental abnormalities in offspring.
METHODS: Our case‒control study involved 97 women with ICP and 152 with uncomplicated pregnancies nested in a cohort of their offspring, including 50 from the ICP group and 87 from the uncomplicated pregnancy group. We collected pediatric growth and development data, with a maximum follow-up duration of 36 months. Stratified analyses of children\'s height, weight, and head circumference were conducted, and Spearman\'s rank correlation was applied to examine the relationships between maternal serological markers and pediatric growth metrics.
RESULTS: Maternal liver and renal functions, along with serum lipid profiles, significantly differed between the ICP and normal groups. In the ICP group, the offspring showed elevated alanine aminotransferase (ALT), direct bilirubin (DBIT), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and apolipoprotein B (APOB) levels. Notably, the length-for-age z score (LAZ), weight-for-age z score (WAZ), and head circumference-for-age z score (HCZ) were lower in ICP offspring compared with those from normal pregnancies within the 1- to 12-month age range (P < 0.05). However, no significant differences in LAZ, weight-for-length z score (WLZ), BMI-for-age z score (BAZ), or HCZ were observed between groups in the 13- to 36-month age range. Maternal maximum lactate dehydrogenase (LDH) and total bile acids (TBA) levels during pregnancy were inversely correlated with LAZ and WAZ in the first year. Furthermore, offspring of mothers with ICP exhibited a greater incidence of stunting (24% vs. 6.9%, P = 0.004) and abnormal HCZ (14% vs. 3.7%, P = 0.034).
CONCLUSIONS: Growth disparities in offspring of ICP-affected pregnancies were most significant within the 1- to 12-month age range. During this period, maximum maternal LDH and TBA levels were negatively correlated with LAZ and WAZ values of offspring. The observation of similar growth rates between ICP and control group offspring from 13 to 36 months suggested catch-up growth in the ICP group.
METHODS: Our case‒control study involved 97 women with ICP and 152 with uncomplicated pregnancies nested in a cohort of their offspring, including 50 from the ICP group and 87 from the uncomplicated pregnancy group. We collected pediatric growth and development data, with a maximum follow-up duration of 36 months. Stratified analyses of children\'s height, weight, and head circumference were conducted, and Spearman\'s rank correlation was applied to examine the relationships between maternal serological markers and pediatric growth metrics.
RESULTS: Maternal liver and renal functions, along with serum lipid profiles, significantly differed between the ICP and normal groups. In the ICP group, the offspring showed elevated alanine aminotransferase (ALT), direct bilirubin (DBIT), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and apolipoprotein B (APOB) levels. Notably, the length-for-age z score (LAZ), weight-for-age z score (WAZ), and head circumference-for-age z score (HCZ) were lower in ICP offspring compared with those from normal pregnancies within the 1- to 12-month age range (P < 0.05). However, no significant differences in LAZ, weight-for-length z score (WLZ), BMI-for-age z score (BAZ), or HCZ were observed between groups in the 13- to 36-month age range. Maternal maximum lactate dehydrogenase (LDH) and total bile acids (TBA) levels during pregnancy were inversely correlated with LAZ and WAZ in the first year. Furthermore, offspring of mothers with ICP exhibited a greater incidence of stunting (24% vs. 6.9%, P = 0.004) and abnormal HCZ (14% vs. 3.7%, P = 0.034).
CONCLUSIONS: Growth disparities in offspring of ICP-affected pregnancies were most significant within the 1- to 12-month age range. During this period, maximum maternal LDH and TBA levels were negatively correlated with LAZ and WAZ values of offspring. The observation of similar growth rates between ICP and control group offspring from 13 to 36 months suggested catch-up growth in the ICP group.
摘要：
背景：妊娠期肝内胆汁淤积症（ICP）与不良胎儿结局的风险增加有关，然而，它对后代生长的影响尚不清楚。我们的研究动态跟踪ICP儿童和健康母亲的生长速度，并调查母亲肝功能与后代发育异常之间的联系。
方法：我们的病例对照研究涉及97名患有ICP的妇女和152名患有无并发症妊娠的妇女，这些妇女的后代是嵌套的。包括ICP组的50例和无并发症妊娠组的87例。我们收集了儿科生长发育数据，最长随访时间为36个月。儿童身高的分层分析，体重,进行了头围，和Spearman的等级相关性用于检查母体血清学标志物与儿科生长指标之间的关系。
结果：产妇肝肾功能，随着血清脂质分布，ICP组与正常组之间存在显著差异。在ICP组中，后代显示丙氨酸转氨酶（ALT）升高，直接胆红素（DBIT），高密度脂蛋白胆固醇（HDL-C），低密度脂蛋白胆固醇（LDL-C），和载脂蛋白B（APOB）水平。值得注意的是,年龄长度z得分(LAZ)，年龄体重z评分（WAZ），与1至12月龄范围内的正常妊娠相比，ICP后代的头围年龄z评分（HCZ）较低（P<0.05）。然而,LAZ没有显著差异，体重长度z得分(WLZ)，BMI年龄z评分（BAZ），或HCZ在13至36月龄的组间观察到。妊娠期母体最高乳酸脱氢酶（LDH）和总胆汁酸（TBA）水平与第一年的LAZ和WAZ呈负相关。此外，患有ICP的母亲的后代表现出更高的发育迟缓发生率(24%与6.9%，P=0.004）和异常HCZ（14%vs.3.7%,P=0.034)。
结论：受ICP影响的妊娠后代的生长差异在1至12月龄范围内最为显著。在此期间,最大母体LDH和TBA水平与后代的LAZ和WAZ值呈负相关。从13到36个月，ICP和对照组后代之间的生长速率相似，这表明ICP组的追赶生长。
方法：我们的病例对照研究涉及97名患有ICP的妇女和152名患有无并发症妊娠的妇女，这些妇女的后代是嵌套的。包括ICP组的50例和无并发症妊娠组的87例。我们收集了儿科生长发育数据，最长随访时间为36个月。儿童身高的分层分析，体重,进行了头围，和Spearman的等级相关性用于检查母体血清学标志物与儿科生长指标之间的关系。
结果：产妇肝肾功能，随着血清脂质分布，ICP组与正常组之间存在显著差异。在ICP组中，后代显示丙氨酸转氨酶（ALT）升高，直接胆红素（DBIT），高密度脂蛋白胆固醇（HDL-C），低密度脂蛋白胆固醇（LDL-C），和载脂蛋白B（APOB）水平。值得注意的是,年龄长度z得分(LAZ)，年龄体重z评分（WAZ），与1至12月龄范围内的正常妊娠相比，ICP后代的头围年龄z评分（HCZ）较低（P<0.05）。然而,LAZ没有显著差异，体重长度z得分(WLZ)，BMI年龄z评分（BAZ），或HCZ在13至36月龄的组间观察到。妊娠期母体最高乳酸脱氢酶（LDH）和总胆汁酸（TBA）水平与第一年的LAZ和WAZ呈负相关。此外，患有ICP的母亲的后代表现出更高的发育迟缓发生率(24%与6.9%，P=0.004）和异常HCZ（14%vs.3.7%,P=0.034)。
结论：受ICP影响的妊娠后代的生长差异在1至12月龄范围内最为显著。在此期间,最大母体LDH和TBA水平与后代的LAZ和WAZ值呈负相关。从13到36个月，ICP和对照组后代之间的生长速率相似，这表明ICP组的追赶生长。
