Analysis Of Pregnancy Outcome And Risk Factors Of Early-onset ICP And Study On The Relationship Between ICP And Preeclampsia

[Objective]To study the serum biochemical indexes and pregnancy outcome of patients with intrahepatic cholestasis of pregnancy with different onset time,and to explore the eff--ect of onset time on ICP patients.To find out the independent risk factors of early-onset ICP,so as to provide reference for the diagnosis,treatment and management of early-onset ICP.to explore the relationship between ICP and preeclampsia and to veri--fy whether ICP is a high risk factor for preeclampsia.[Method]1.A total of 128 ICP patients with complete data were selected from the Third Affiliated Hospital of Southern Medical University and Shenzhen Hospital of Sou--thern Medical University from January 1,2010 to January 1,2020.The patients were divided into two groups according to 28 weeks of gestation.Early onset ICP group:onset gestational age<28 weeks group;Late onset ICP group:onset gestational age ≥28 weeks.The serum biochemical indexes and pregnancy outcome of the two groups were analyzed.2.Univariate analysis was performed on gestational age,gravida,parity,BMI,family history of ICP,twins,complications(diabetes,hypertension,hepatitis B virus infection),liver function indexes(ALT,AST,DBil,IBil,ALP,GGT,TP,ALB)and other indexes(Hb,PLT,UN,Cr)of patients with early-onset ICP and late-onset ICP.According to the results of univariate analysis,the influencing factors with significant differences were included in binary Logistic regression analysis to find out the indep--endent risk factors affecting early-onset ICP.3.128 patients with ICP were selected as the experimental group,and 4162 normal pregnant women in the same period as the control group.The incidence of preeclampsia was compared between the two groups.At the same time,patients with ICP were divided into groups according to gestational weeks of onset and severity of illness,and the correlation between different gestational weeks,different degrees of ICP and preeclampsia was compared.[Result]1.(1)Comparing the general data of age(y),weight(kg),height(cm),BMI(kg/m2),gravida and parity between the two groups,and the results showed that there was no significant difference between the two groups(P>0.05).(2)The level of serum TBA in patients with early-onset ICP was significantly higher than that in patie--nts with late-onset ICP,while the levels of ALP,Cr and BUN in the early onset ICP group were significantly lower than those in the late onset ICP group(P<0.05).However,There was no significant difference in liver function indexes such as ALT,AST,GGT,DBil,IBil,TP,ALB and other indexes such as Hb and PLT,between the two groups(P>0.05).(3)The incidence of severe ICP,cesarean section,preterm delivery,conversion to neonatal pediatrics after delivery and the amount of bleeding during delivery in the early-onset ICP group were higher than those in the late-onset ICP group.The birth weight in the late-onset ICP group was higher than that in the early-onset ICP group.The above differences were statistically significant(P<0.05).Although the proportion of low birth weight,the incidence of fetal growth restriction,meconium-stained amniotic fluid,neonatal asphyxia and fetal distress in the early-onset ICP group were higher than those in the late-onset ICP group,the difference was not statistically significant(P>0.05).2.ALP,Cr and BUN with statistically significant differences in univariate analysis were included in binary Logistic regression,and only ALP variable was significant among the last three predictive factors(OR=0.989,95%CI:0.981-0.997,P<0.05).3.(1)The incidence of preeclampsia in the ICP group was 6.3%,which was significantly higher than that in the normal control group(2.3%)(P<0.05).(2)The incidence of preeclampsia in the early-onset ICP group was slightly higher than that in the normal control group(4.3%vs 2.3%),but the difference was not statisti-cally significant(P>0.05).The incidence of preeclampsia in the late-onset ICP group was 7.4%,which was significantly higher than that in the normal control group(2.3%)(P<0.05).(3)The incidence of preeclampsia in mild ICP group was 8.9%,which was significantly higher than that in normal control group(2.3%).The difference between the two groups was statistically significant(P<0.05).However,there was no significant difference in the incidence of preeclampsia between the severe ICP group and the normal control group(P>0.05).[Conclusion]1.With 28 weeks as the time boundary,there were significant differences in serum biochemical indexes(TBA,ALP,Cr,BUN)and pregnancy outcome(preterm delivery,neonatal transfer to pediatrics,neonatal birth weight,cesarean section,intrapartum blood loss,severe ICP)between early-onset ICP group and late-onset ICP group.The condition of patients with early-onset ICP was more serious,and the pregnancy outcome was worse.2.It was found for the first time that ALP was an independent risk factor for early-onset ICP.With each increase of one unit in ALP,the incidence of early-onset in ICP patients decreased by 1.1%,which can be used as a predictor.3.There is indeed a correlation between ICP and preeclampsia.The incidence of preeclampsia in patients with ICP is significantly higher than that in normal controls.ICP is one of the high risk factors of preeclampsia.