Intrahepatic Cholestasis Of Pregnancy (ICP) And Perinatal Outcomes:System Review And Meta-analysis

Objective:To investigate the relationship between intrahepatic cholestasis(ICP)and perinatal outcome in 19 subjects in the last 15 years.Methods:A total of 4399 cases were observed about the relationship between intrahepatic cholestasis of pregnancy and fetal distress.2662 ICP patients were classified as case group according to bile acid and liver enzyme index,and 1737 normal pregnant women were used as control group to analyze fetal distress in pregnancy outcome in 2 groups.A total of 4541 subjects were observed on the relationship between intrahepatic cholestasis of pregnancy and neonatal asphyxia.Based on bile acids and Hepatic enzyme index included 2830 ICP patients as case group and 1711 normal pregnant women as control group to analyze the neonatal asphyxia in the pregnancy outcome of group 2.Results:Meta analysis showed that the OR value of intrahepatic cholestasis and fetal distress in pregnancy was 3.97[3.24,4.88],and the lower limit CI 95%was more than 1,indicating that the risk of neonatal asphyxia was higher in pregnant intrahepatic cholestasis than in control group,suggesting that fetal distress was related to intrahepatic cholestasis of pregnancy.Meta analysis showed that the combined OR value of intrahepatic cholestasis of pregnancy and neonatal asphyxia was 2.99[2.28,3.93],and the lower limit CI 95%was more than 1,indicating that the risk of neonatal asphyxia in pregnant intrahepatic cholestasis was higher than that in control group,suggesting that neonatal asphyxia was associated with intrahepatic cholestasis of pregnancy.The probability of fetal distress and neonatal asphyxia in ICP group was significantly higher than that in control group(P<0.00001).The difference between case group and control group was statistically significant(P<0.05).Pregnant women with intrahepatic cholestasis of pregnancy(ICP)have strong correlation with fetal distress and neonatal asphyxia.Conclusion:Pregnant women with intrahepatic cholestasis of pregnancy(ICP)have strong correlation with fetal distress and neonatal asphyxia.Therefore,the monitoring of liver function index of intrahepatic cholestasis of pregnancy should be strengthened in order to evaluate the ICP maternal and neonatal outcome,carry out fetal monitoring in time,ensure pregnancy safety,and prepare ahead of time for termination of pregnancy and neonatal asphyxia rescue.