与妊娠的渐进性肝内胆固醇症相关的不良结果
Minhazur R Sarker1,2,3, Dana Canfield1, Lauren Ferrara2,3
1Department of Obstetrics, Gynecology and Reproductive Science, University of California San Diego, San Diego, California.
American journal of perinatology
|November 26, 2024
概括
监测胆汁酸水平的峰值在怀孕中至关重要. 渐进性或严重的胆固醇症与轻度病例相比,显著增加了不良妊娠结果的风险.
科学领域:
- 围产儿医学 围产儿医学
- 孕产妇和胎儿医学 孕产妇和胎儿医学
- 产科 产科 产科 产科 产科
背景情况:
- 怀孕的肝脏内胆固醇症 (ICP) 是怀孕中独特的肝脏疾病.
- 胆酸水平是ICP严重性的一个关键指标.
- 渐进性ICP与不良结果之间的关联需要进一步阐明.
研究的目的:
- 调查胆汁酸水平在怀孕中增加的胆汁酸和不良的孕产妇和新生儿结局之间的关系.
- 为了比较不同严重程度的胆固醇病的不良结果:轻微,渐进和严重.
主要方法:
- 单个,非异常怀孕与胆固醇症的回顾性队列研究 (2005-2019).
- 胆固醇病被分类为轻度 (初始和峰值总胆汁酸[TBA]<40μmol/L),渐进性 (初始TBA<40μmol/L,峰值TBA≥40μmol/L) 和严重 (初始TBA≥40μmol/L).
- 评估了一个复合的不良结果,包括早产,低动脉pH值,低Apgar分数,剖腹产对胎儿的痛苦,染液体,和NICU入院.
主要成果:
- 在1,182个怀孕中,61.9%的怀孕有轻度胆固醇,6.6%的进展性胆固醇和31.5%的严重胆固醇.
- 调整后的分析显示,与轻度胆固醇相比,渐进性胆固醇 (OR 1.70) 和严重胆固醇 (OR 1.60) 都与不良结果有显著的关联.
- 在渐进性胆固醇和严重胆固醇之间没有观察到显著的结果差异,当渐进性胆固醇是比较剂时.
结论:
- 峰值总胆汁酸 (TBA) 水平比胆固醇中初始的TBA水平更能表明妊娠的不良结果.
- 胆固醇症可以在怀孕期间进展,监测这些变化对于风险评估至关重要.
- 进一步的研究是有必要的,以探索趋势胆酸水平在管理胆固醇病的临床实用性.
更多相关视频
08:50A Murine Model of Fetal Exposure to Maternal Inflammation to Study the Effects of Acute Chorioamnionitis on Newborn Intestinal Development
Published on: June 24, 2020
3.7K
08:56Bile Duct Ligation in Mice: Induction of Inflammatory Liver Injury and Fibrosis by Obstructive Cholestasis
Published on: February 10, 2015
52.1K
相关概念视频
01:24Chronic Pancreatitis I: Introduction
72
The pancreas, an elongated and flat gland situated behind the stomach, serves a vital function in digesting food and managing blood sugar levels.
Pancreatitis is the inflammation of the pancreas, which occurs when the immune system becomes active and causes swelling, pain, and disruptions in organ function. Pancreatitis can manifest as either an acute or chronic condition.
Acute pancreatitis arises suddenly and lasts for a brief duration, while chronic pancreatitis is a long-term affliction...
Pancreatitis is the inflammation of the pancreas, which occurs when the immune system becomes active and causes swelling, pain, and disruptions in organ function. Pancreatitis can manifest as either an acute or chronic condition.
Acute pancreatitis arises suddenly and lasts for a brief duration, while chronic pancreatitis is a long-term affliction...
72
01:27Inflammatory Bowel Disease I: Ulcerative Colitis
138
Introduction
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
138
01:17Chronic Bowel Disorders: Introduction
388
Chronic bowel diseases are a group of long-term conditions affecting the digestive tract, characterized by inflammation and damage to the gut lining. These conditions primarily include irritable bowel syndrome and inflammatory bowel disease.
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
388
01:07Teratogenicity
2.4K
The ability of a drug to produce structural deformations and functional abnormalities in the developing embryo or the fetus is called teratogenicity, and the drug producing this effect is known as a teratogen. Teratogenic effects include stillbirth, miscarriage, intrauterine growth restriction, and neurocognitive delay. A teratogen may affect the embryo at different stages of development, which is important in determining the type and extent of the damage. During blastocyst formation, the early...
2.4K
01:30Acute Pancreatitis II: Clinical Manifestations and Management
93
Acute pancreatitis presents a complex medical emergency characterized by rapid onset inflammation of the pancreas, demanding timely diagnosis and management to prevent complications. The condition primarily manifests through severe upper abdominal pain that often radiates to the back. This pain intensifies following the consumption of fatty foods. Accompanying symptoms such as nausea, vomiting, abdominal distention, fever, dyspnea, cyanosis, and jaundice can vary in intensity but significantly...
93
01:29Chronic Pancreatitis II: Collaborative Care
70
The management of chronic pancreatitis is multifaceted, involving a comprehensive approach that includes thorough assessment, diagnostic testing, and a variety of management strategies.
Assessment:
Assessment:
70