The Clinical Study Of HBV On Pregnancy Outcome In Pregnant Women With ICP

Objective Study of the effects of hepatitis B virus(HBV)on biochemical indicators and perinatal outcomes in pregnant women with intrahepatic cholestasis of pregnancy(ICP).Methods(1)Retrospective analysis of 366 cases of pregnant women who were born and delivered in the Department of Obstetrics and Gynecology,Shanghai Public Health Clinical Center,Fudan University from December 2013 to March 2016,Among them,There were 133 cases of HBV-negative ICP group(hereinafter referred to as simple ICP group).There were 233 cases in the HBV positive ICP:155 cases of HBeAg-positive HBV group(hereinafter referred to as HBeAg-positive group);78 cases of HBeAg-negative HBV group(hereinafter referred to as HBeAg-negative group).(2)Recording the laboratory data of the age,parity,diagnosis gestational age,delivery gestational week,liver function during pregnancy(including the first onset,the most severe condition during pregnancy(before treatment),and after treatment close to delivery),itching,pregnancy outcome(fetal distress,III degree amniotic fluid fecal infection,oligohydramnios,spontaneous preterm birth and postpartum hemorrhage),neonatal weight,neonatal Apgar score,neonatal asphyxia.(3)Statistics and analysis of biochemical indicators and pregnancy outcomes.Results(1)There were no significant differences between the three groups in terms of age,parity,diagnosis gestational age,and itching(P>0.05).The three groups of total bile acid and transaminase decreased significantly after treatment,and there was significant difference between the two groups before and after treatment(P<0.05).(2)HBeAg positive group and ICP group,HBeAg positive group and HBeAg negative group:total bile acid and transaminase before and after treatment were statistically different;meconium stained amniotic fluid(MSAF),postpartum hemorrhage,fetal distress,spontaneous premature delivery,too little amniotic fluid,neonatal asphyxia,The incidence of all was significantly higher in the HBeAg-positive group than in the simple ICP group and the HBeAg-negative group,and there was a statistical difference(P<0.05).There were no significant differences in biochemical parameters and maternal and fetal outcomes between the simple ICP group and the HBeAg-negative group(P>0.05).(3)Serum biochemical monitoring index as an independent variable,the unhealthy mothers and children outcomes as a dependent variable,Logistic single factor and multi-factor regression analysis showed that the total bile acid level before and after treatment and HBeAg positive were independent risk factors for the ban maternal and child outcomes.Conclusions HBeAg-positive with elevated total bile acid is more serious in pregnant women and should be taken seriously in clinical practice.