妊娠期肝内胆汁淤积症流行病学调查及危险因素分析

目的:研究妊娠期肝内胆汁淤积症(ICP)流行病学分布特征及相关危险因素。方法:选取2015年10月—2019年10月于甘肃省陇西县第一人民医院住院的孕妇3 702例为样本进行横断面研究,采集孕妇基线资料,同时记录孕妇受精方式、孕周及妊娠期合并症发生情况并完善实验室检查,根据ICP发病情况将患者分为ICP组和对照组,比较两组各项资料并分析ICP发病危险因素。结果:3 702例孕妇中确诊为ICP者158例(4.27%),两组孕妇年龄、妊娠时间、居住地、受教育年限、ICP家族史、孕激素应用、多胎妊娠、自身免疫疾病、妊娠期糖尿病及妊娠期高血压等流行病学分布特征比较,差异均有统计学意义(P<0.05);多因素logistic回归分析显示,年龄、孕周、受教育年限、ICP家族史、多胎妊娠及自身免疫疾病均为ICP发病的独立危险因素(P<0.05)。结论:年龄、孕周、受教育年限、ICP家族史、多胎妊娠以及自身免疫疾病均为影响ICP发病的危险因素,孕期需加强监测和筛查工作,以保障母婴健康。

Epidemiological Investigation and Risk Factors Analysis of Intrahepatic Cholestasis of Pregnancy

OBJECTIVE To study the epidemiological characteristics and related risk factors of intrahepatic cholestasis of pregnancy(ICP). METHODS 3 702 pregnant female hospitalized in target hospital from October 2015 to October 2019 were taken as samples for cross-sectional study, and the baseline data of pregnant female were collected. The fertilization pattern, gestational weeks and occurrence of pregnancy complication were recorded, and laboratory examination were completed. According to the incidence of ICP,the patients were divided into ICP group and control group. The data of these two groups were compared and the risk factors of ICP were analyzed. RESULTS Among the 3 702 pregnant women, 158 cases were diagnosed with ICP(4.27%). There were significant differences in the epidemiological distribution characteristics of age, pregnancy time, place of residence, education years, family history of ICP, progestin application, multiple pregnancy, autoimmune disease, gestational diabetes mellitus and gestational hypertension between these two groups(P<0.05). Multivariate Logistic regression analysis showed that age, gestational weeks, education years, family history of ICP, multiple pregnancy and autoimmune diseases were independent risk factors for ICP(P<0.05). CONCLUSION Age,gestational week, education years, family history of ICP, multiple pregnancy and autoimmune disease were all risk factors that affect the incidence of ICP I id necessary to strengthen the monitoring and screening during pregnancy so as to ensure the health of mothers and infants.