Risk factors for intrahepatic cholestasis of pregnancy

LIU Mingting; JIANG Yunlan; MAI Xiaoping; LU Yutong; LI Jie; LIAO Shiqin

doi:10.3969/j.issn.2096-3351.2023.03.009

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Risk factors for intrahepatic cholestasis of pregnancy

更新时间：2023-05-25

- Risk factors for intrahepatic cholestasis of pregnancy
- Journal of Southwest Medical University Vol. 46, Issue 3, Pages: 226-232(2023)
- 作者机构：
  
  1. 成都中医药大学护理学院,成都,610075
  2. 成都中医药大学附属医院护理部,成都,610075
  3. 成都中医药大学附属医院妇科,成都,610072
- 作者简介：
- 基金信息：
- DOI：10.3969/j.issn.2096-3351.2023.03.009
  CLC：
- Published：2023，
  
  Published Online：20 May 2023，
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LIU Mingting, JIANG Yunlan, MAI Xiaoping, et al. Risk factors for intrahepatic cholestasis of pregnancy. [J]. Journal of Southwest Medical University 46(3):226-232(2023)
DOI：

LIU Mingting, JIANG Yunlan, MAI Xiaoping, et al. Risk factors for intrahepatic cholestasis of pregnancy. [J]. Journal of Southwest Medical University 46(3):226-232(2023) DOI： 10.3969/j.issn.2096-3351.2023.03.009.

摘要

目的系统评价妊娠期肝内胆汁淤积症（intrahepatic cholestasis of pregnancy，ICP）的危险因素，以期为临床医护人员早期识别、提早做出风险策略提供循证医学依据。方法通过计算机搜索PubMed、Embase、The Cochrane Library、Web Of Science、CNKI、VIP、WanFangData、CBM 数据库中关于妊娠期肝内胆汁淤积症危险因素的相关研究，并手动检索其他途径文献，检索期限从建库至2022 年11 月。研究类型主要包括病例对照、队列研究。结果纳入24 篇文献，包括21 篇中文，3 篇英文文献，共61 650 例病人，Meta 分析结果显示：高龄（OR = 1.42，95%CI 1.17 ~ 1.72）、ICP 家族史或疾病史（OR = 6.17，95%CI 4.66 ~ 8.16）、乙肝病毒感染或合并肝胆疾病（OR = 4.12，95%CI 3.61 ~ 4.69）、妊娠期高血压（OR = 4.01，95%CI 3.30 ~ 4.88）、妊娠期糖尿病（OR = 4.59，95%CI 3.30 ~ 6.39）、自身免疫性疾病（OR = 4.91，95%CI 3.78 ~ 6.38）、尿蛋白阳性（OR = 6.43，95%CI 4.22 ~ 9.81）、高雌激素（OR = 26.90，95%CI 19.53 ~ 37.06）、孕激素保胎治疗（OR = 3.04，95%CI 2.51 ~ 3.68）、多胎妊娠（OR = 15.64，95%CI 7.95 ~ 30.75）、低硒摄入量（OR = 8.52，95%CI 6.37 ~ 11.41）、低锌摄入量（OR = 2.90，95%CI 1.97 ~ 4.26）、产次≥ 2（OR =0.12，95%CI 0.08 ~ 0.16）是妊娠期肝内胆汁淤积症的主要危险因素，差异均有统计学意义（ P < 0.05）。结论高龄、ICP 家族史或疾病史、乙肝病毒感染或合并肝胆疾病、妊娠期高血压、妊娠期糖尿病、自身免疫性疾病、尿蛋白阳性、高雌激素、孕激素保胎治疗、多胎妊娠、低硒摄入量、低锌摄入量、产次≥ 2 是妊娠期肝内胆汁淤积症的危险因素。

Abstract

Objective To systematically evaluate the risk factors of intrahepatic cholestasis of pregnancy，in order to provide evidence-based support for clinical staff to identify and make risk strategies in advance.Methods By searching PubMed，Embase，The Cochrane Library，Web of Science，CNKI，VIP，WanFang Data and CBM databases for relevant studies on the risk factors of intrahepatic cholestasis of pregnancy，and manually searching other literatures.The retrieval period is from the establishment of the database to No⁃ vember 2022.The types of studies mainly included case control studies.Results Twenty-one literatures were included，with a total of 61650 patients.The results of meta-analysis showed that: Advanced age（OR = 1.42，95%CI 1.17 ~ 1.72），family OR medical history of ICP（OR = 6.17，95%CI 4.66 ~ 8.16），hepatitis B virus infection OR combined hepatobiliary disease（OR = 4.12，95%CI 3.61 ~ 4.69），hypertension during pregnancy（OR = 4.01，95%CI 3.30 ~ 4.88），gestational diabetes mellitus（OR = 4.59，95%CI 3.30 ~ 6.39），auto⁃ immune disease（OR = 4.91，95%CI 3.78 ~ 6.38），urine protein positive（OR = 6.43，95%CI 4.22 ~ 9.81），high estrogen（OR = 26.90，95%CI 19.53 ~ 37.06），progesterone treatment（OR = 3.04，95%CI 2.51 ~ 3.68），multiple pregnancy（OR = 15.64，95%CI 7.95 ~ 30.75），low selenium intake（OR = 8.52，95%CI 6.37 ~ 11.41）、low zinc intake（OR = 2.90，95%CI 1.97 ~ 4.26）and multiparous （OR = 0.12，95%CI 0.08 ~ 0.16）were the main risk factors for intrahepatic cholestasis during pregnancy，and the difference was statis⁃ tically significant（P < 0.05）.Conclusions Advanced age，family history or history of ICP，hepatitis B virus infection or combined hepatobiliary disease，gestational hypertension，gestational diabetes，autoimmune disease，positive urinary protein，high estrogen，proges⁃ terone fetal preservation therapy，multiple pregnancies，low selenium intake，low zinc intake and multiparous were the main risk factors for intrahepatic cholestasis of pregnancy.

关键词

妊娠期肝内胆汁淤积妊娠期肝内胆汁淤积症危险因素

Keywords

Gestation periodIntrahepatic cholestasisIntrahepatic cholestasis of pregnancyRisk factors

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