PDF(Pubmed)
Abstract：
BACKGROUND: What kinds of fetal adverse outcomes beyond stillbirth directly correlate to the severity of intrahepatic cholestasis during pregnancy (ICP) remained tangled. Herein, we conducted a retrospective cohort study and a dose-response meta-analysis to speculate the association between the severity of ICP and its adverse outcomes.
METHODS: We retrospectively collected a cohort of ICP patients from electronic records from Guangzhou Women and Children\'s Medical Center between Jan 1st, 2018, and Dec 31st, 2022. Also, we searched PubMed, Cochrane, Embase, Scopus, and Web of Science to extract prior studies for meta-analysis. The Kruskal-Wallis test, a one-way or two-way variants analysis (ANOVA), and multi-variant regression are utilized for cohort study. One stage model, restricted cubic spline analysis, and fixed-effect model are applied for dose-response meta-analysis. The data analysis was performed using the R programme.
RESULTS: Our cohort included 1,289 pregnant individuals, including 385 mild ICP cases, 601 low moderate ICP cases, 282 high moderate ICP cases, and 21 severe ICP cases. The high moderate bile acid levels were correlated to preterm birth [RR = 2.14, 95%CI 1.27 to 3.62), P < 0.01], and preterm premature rupture of membranes [RR = 0.34, 95%CI 0.19 to 0.62), P < 0.01]. We added our cases to cases reported by other studies included in the meta-analysis. There were 15,826 patients included in dose-response meta-analysis. The severity of ICP was associated with increased risks of stillbirth, spontaneous preterm birth, iatrogenic preterm birth, preterm birth, admission to neonatal intensive care unit, and meconium-stained fluid (P < 0.05).
CONCLUSIONS: Our study shows the correlation between the severity of ICP and the ascending risks of stillbirth, preterm birth, and meconium-stained fluid, providing new threshold TBA levels.
UNASSIGNED: CRD42023472634.
METHODS: We retrospectively collected a cohort of ICP patients from electronic records from Guangzhou Women and Children\'s Medical Center between Jan 1st, 2018, and Dec 31st, 2022. Also, we searched PubMed, Cochrane, Embase, Scopus, and Web of Science to extract prior studies for meta-analysis. The Kruskal-Wallis test, a one-way or two-way variants analysis (ANOVA), and multi-variant regression are utilized for cohort study. One stage model, restricted cubic spline analysis, and fixed-effect model are applied for dose-response meta-analysis. The data analysis was performed using the R programme.
RESULTS: Our cohort included 1,289 pregnant individuals, including 385 mild ICP cases, 601 low moderate ICP cases, 282 high moderate ICP cases, and 21 severe ICP cases. The high moderate bile acid levels were correlated to preterm birth [RR = 2.14, 95%CI 1.27 to 3.62), P < 0.01], and preterm premature rupture of membranes [RR = 0.34, 95%CI 0.19 to 0.62), P < 0.01]. We added our cases to cases reported by other studies included in the meta-analysis. There were 15,826 patients included in dose-response meta-analysis. The severity of ICP was associated with increased risks of stillbirth, spontaneous preterm birth, iatrogenic preterm birth, preterm birth, admission to neonatal intensive care unit, and meconium-stained fluid (P < 0.05).
CONCLUSIONS: Our study shows the correlation between the severity of ICP and the ascending risks of stillbirth, preterm birth, and meconium-stained fluid, providing new threshold TBA levels.
UNASSIGNED: CRD42023472634.
摘要：
背景：除死胎外，哪些胎儿不良结局与妊娠期肝内胆汁淤积症（ICP）的严重程度直接相关。在这里，我们进行了一项回顾性队列研究和剂量-反应荟萃分析,以推测ICP的严重程度与其不良结局之间的关联.
方法：我们从广州妇女儿童医疗中心1月1日之间的电子记录中收集了一组ICP患者，2018年12月31日，2022年。此外，我们搜索了PubMed,科克伦,Embase,Scopus,和WebofScience提取先前的研究进行荟萃分析。Kruskal-Wallis测试,单向或双向变异分析(ANOVA)，多变量回归用于队列研究。一个阶段模型，受限三次样条分析,和固定效应模型用于剂量反应荟萃分析。使用R程序进行数据分析。
结果：我们的队列包括1,289名孕妇，包括385例轻度ICP,601例低中度ICP病例，282例高中度ICP病例，和21例严重ICP病例。高中度胆汁酸水平与早产相关[RR=2.14，95CI1.27至3.62），P<0.01],和早产胎膜早破[RR=0.34，95CI0.19至0.62），P<0.01]。我们将我们的病例添加到荟萃分析中其他研究报告的病例中。有15,826例患者纳入剂量反应荟萃分析。ICP的严重程度与死产风险增加有关，自发性早产,医源性早产,早产,入住新生儿重症监护室，和胎粪污染液（P<0.05）。
结论：我们的研究表明ICP的严重程度与死产风险上升之间存在相关性，早产,和胎粪污染的液体，提供新的阈值TBA水平。
■CRD42023472634。
方法：我们从广州妇女儿童医疗中心1月1日之间的电子记录中收集了一组ICP患者，2018年12月31日，2022年。此外，我们搜索了PubMed,科克伦,Embase,Scopus,和WebofScience提取先前的研究进行荟萃分析。Kruskal-Wallis测试,单向或双向变异分析(ANOVA)，多变量回归用于队列研究。一个阶段模型，受限三次样条分析,和固定效应模型用于剂量反应荟萃分析。使用R程序进行数据分析。
结果：我们的队列包括1,289名孕妇，包括385例轻度ICP,601例低中度ICP病例，282例高中度ICP病例，和21例严重ICP病例。高中度胆汁酸水平与早产相关[RR=2.14，95CI1.27至3.62），P<0.01],和早产胎膜早破[RR=0.34，95CI0.19至0.62），P<0.01]。我们将我们的病例添加到荟萃分析中其他研究报告的病例中。有15,826例患者纳入剂量反应荟萃分析。ICP的严重程度与死产风险增加有关，自发性早产,医源性早产,早产,入住新生儿重症监护室，和胎粪污染液（P<0.05）。
结论：我们的研究表明ICP的严重程度与死产风险上升之间存在相关性，早产,和胎粪污染的液体，提供新的阈值TBA水平。
■CRD42023472634。
