Correlation Between Intrahepatic Cholestasis Of Pregnancy(ICP)and Early Neonatal Hyperbilirubinemia

Objective: To investigate the correlation between intrahepatic cholestasis of pregnancy(ICP)and neonatal hyperbilirubinemia in the early stage of pregnancy.Methods: from January 2017 to December 2017 in Wanbei Coal Group general hospital routine pregnancy test,ICP delivery maternal 86 cases as the study group,and the ICP of newborns delivered by mothers as the A group;selected the same period of normal pregnancy and childbirth 120 cases of pregnant women as control group,normal pregnancy childbirth 120 cases as B group.Comparison between the study group and the control group in pregnancy the blood indexes of TBA,TBIL,DBIL,ALT,AST;pregnancy outcome were compared between the two groups of neonates;of different delivery time,different delivery modes were compared with the incidence of hyperbilirubinemia;correlation between ICP patients with various biochemical indicators and high bilirubinemia.Results: the study group of pregnancy in the indexes of TBA,TBIL,DBIL,ALT and AST were significantly higher than that of the control group(P<0.05);group of neonates hyperbilirubinemia in 38 cases,the incidence rate of44.19%,control group 20 cases of neonates hyperbilirubinemia incidence,incidence rate of 16.67%,A group of neonatal hyperbilirubinemia was significantly higher in group B(P<0.05);group A,neonatal birth weight was significantly lower than B group(P<0.05);group of meconium stained rate(23.26%),premature birth rate(44.19%),cesarean section rate(61.63%),asphyxia(22.09%),death rate(5.17%),were significantly higher than the control group(10.83% rate of meconium stained)(14.17%),premature delivery rate,cesarean section rate(35.83%),asphyxia(9.17%),mortality(0%)(P<0.05);A group was significantly higher than that in premature neonates hyperbilirubinemia The same group of newborns(P<0.05);A and B two groups in premature and full-term neonatal hyperbilirubinemia were no significant difference(P>0.05);A group of 30 cases of neonatal cesarean section,cesarean section rate of78.95% was significantly higher than that of B group 40%(P<0.05);A group of neonatal spontaneous delivery rate of 21.05%,significantly lower than B group nature the delivery rate of 60%(P<0.05);the incidence of neonatal hyperbilirubinemia was significantly higher than the probability of severe ICP patients in control group(P<0.05),it was also found that the neonatal hyperbilirubinemia in patients with ICP,TBA,TBIL,DBIL in maternal serum index level were positively correlated(r=0.315,0.293,0.401,P<0.05);maternal serum ALT,AST and neonatal hyperbilirubinemia without obvious correlation(P>0.05).Conclusion: the incidence of hyperbilirubinemia in newborn infants with ICP pregnancy is higher.Meanwhile,bilirubin level,cholic acid concentration and adverse pregnancy outcomes during pregnancy were related to neonatal hyperbilirubinemia,but there was no significant correlation between AST and ALT levels and neonatal hyperbilirubinemia.Therefore,for the diagnosis of ICP pregnancy,we should consider the change of all biochemical indicators in the laboratory,we should also consider the clinical manifestations,family heredity and other reasons,so as to increase the accuracy of ICP diagnosis.In addition,the clinical management of early ICP pregnancy patients should be strengthened.Timely and effective clinical interventions should be taken to reduce the incidence of hyperbilirubinemia and improve the adverse outcome of pregnancy,which is very important for improving the quality of newborns.