摘要
目的 探讨妊娠期肝内胆汁淤积症(intrahepatic cholestasis of pregnancy,ICP)合并乙肝病毒(HBV)感染对围产期母胎的妊娠结局影响,为改善孕产妇及新生儿围产期结局提供理论依据。方法 选取2020年1月—2022年1月在北京市通州区妇幼保健院医院产科分娩的84例ICP合并HBV感染的孕妇为观察组,以200例单纯ICP患者为对照组。收集患者一般情况、孕期合并症、血常规及生化指标以及新生儿情况等资料,比较ICP合并HBV组和单纯ICP组间的差异。结果 观察组孕妇的孕前体重指数(χ^(2)=2.842,P=0.015)、妊娠期糖尿病(χ^(2)=4.945,P=0.026)、妊娠期高血压疾病(χ^(2)=6.917,P=0.009)、脂肪肝(χ^(2)=9.725,P=0.002)、肝功能异常(χ^(2)=8.687,P=0.003)、胎膜早破(χ^(2)=7.507,P=0.006)、羊水污染(χ^(2)=11.435,P=0.001)、宫内感染(χ^(2)=26.056,P<0.001)、产褥期感染(χ^(2)=7.857,P=0.005)、产后出血(χ^(2)=4.173,P=0.041)比例均高于对照组,观察组早产(χ^(2)=13.399,P<0.001)、胎儿生长受限(χ^(2)=7.328,P=0.007)、胎儿宫内窘迫(χ^(2)=7.303,P=0.007)、高胆红素血症(χ^(2)=6.473,P=0.011)比例均高于对照组,新生儿体重小于对照组(χ^(2)=-8.007,P<0.001)。结论 ICP合并HBV患者与单纯ICP患者相比,产妇及新生儿的围生期不良结局的发生率更高,孕期应严密监测。
Objective To explore the effect of intrahepatic cholestasis of pregnancy(ICP)combined with hepatitis B virus(HBV)infection on the pregnancy outcome of perinatal mothers and fetuses,and to provide theoretical basis for improving the perinatal outcome of pregnant women and newborns.Methods From January 2020 to January 2022,84 pregnant women with ICP and HBV who gave birth in the obstetrics department of Maternal and Child Health Hospital of Tongzhou District were selected as the observation group,and 200 patients with simple ICP were selected as the control group.The general condition,pregnancy complications,blood routine and biochemical indexes and neonatal conditions of the patients were collected,and the differences between the ICP combined with HBV group and the simple ICP group were compared.Results The proportions of pre-pregnancy body mass index(x^(2)=2.842,P=0.015),gestational diabetes mellitus(x^(2)=4.945,P=0.026),hypertensive disorder complicating pregnancy(x^(2)=6.917,P=0.009),fatty liver(x^(2)=9.725,P=0.002),abnormal liver function(x^(2)=8.687,P=0.003),premature rupture of membranes(x^(2)=7.507,P=0.006),amniotic fluid contamination(x^(2)=11.435,P=0.001),intrauterine infection(x^(2)=26.056,P<0.001),puerperal infection(x^(2)=7.857,P-0.005)and postpartum hemorrhage(x^(2)=4.173,P-0.041)in the observation group were higher than those in the control group.The proportions of premature delivery(x^(2)=13.399,P<0.001),fetal growth restriction(x^(2)=7.328,P=0.007),fetal distress(2=7.303,P=0.007)and hyperbilirubinemia(x^(2)=6.473,P=0.011)in the observation group were higher than those in the control group,and the neonatal weight(x^(2)=-8.007,P<0.001)was lower than that in the control group.Conclusion Compared with ICP patients,ICP patients with HBV had a higher incidence of perinatal adverse outcomes in maternal and neonatal periods,and should be closely monitored during pregnancy.
作者
张红
王春月
ZHANG Hong;WANG Chunyue(Maternal and Child Health Hospital of Tongzhou District,Beijing 101101,China)
出处
《中国国境卫生检疫杂志》
CAS
2023年第2期171-174,共4页
Chinese Journal of Frontier Health and Quarantine
关键词
妊娠
肝内胆汁淤积症
乙肝病毒
围产期结局
Pregnancy
Intrahepatic cholestasis
Hepatitis B virus
Perinatal outcome
