在怀孕期间进行肝功能测试的参考范围,以控制母亲的特征
Hannah R Judah1, Robert A Rigby2, Mikis D Stasinopoulos2
1Fetal Medicine Research Institute, King's College Hospital, London, United Kingdom.
American journal of obstetrics and gynecology
|July 3, 2025
概括
在怀孕期间进行准确的肝功能测试需要根据妊娠年龄和母亲因素进行调整. 这项研究提供了新的参考范围和在线计算器,以更好地诊断怀孕期间的肝功能障碍.
科学领域:
- 产科和妇科 产科和妇科
- 孕产妇和胎儿医学 孕产妇和胎儿医学
- 临床生物化学 临床生物化学
背景情况:
- 肝功能障碍影响了3%的怀孕,增加了孕产妇和围产期的风险.
- 准确的诊断依赖于既定的参考范围,这些范围通常没有根据年龄或性别进行调整.
- 现有的妊娠肝功能测试研究缺乏对母亲人口统计和妊娠年龄的控制.
研究的目的:
- 为了确定无并发性怀孕中肝功能测试的参考范围.
- 调整这些范围以怀孕年龄和母亲人口统计特征来调整.
- 开发一个在线z-score计算器用于母乳肝功能测试.
主要方法:
- 对3451名健康的孕妇进行了横截面研究,分别对四次妊娠年龄访问进行了检查.
- 排除有肝功能障碍史或不良结果的妇女.
- 利用位置,尺度和形状 (gamlss) 的通用化添加模型来分析肝功能测试 (ALP,ALT,AST,GGT, bilirubin,ALB) 的分布.
主要成果:
- 妊娠年龄和种族独立预测肝功能测试分布.
- 母亲的体重指数,年龄,平价,吸烟和体重也影响了测试结果.
- 在线z-score计算器可在https://fetalmedicinefoundation.shinyapps.io/life/上使用.
结论:
- 对于母亲肝功能测试的参考范围必须考虑到妊娠年龄和人口因素.
- 调整这些变量对于准确解释怀孕期间的肝功能测试至关重要.
- 这种方法有助于在怀孕期间及时诊断肝功能障碍.
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