J Hepatol:妊娠期非酒精性脂肪性肝病与孕产妇及围产期不良结局相关

2020-07-19 佚名 临床肝胆病杂志

非酒精性脂肪性肝病(NAFLD)在青年人群中的发病率呈上升趋势,该疾病对育龄期妇女具有潜在的影响。目前尚不清楚妊娠期NAFLD是否给孕期或围产期健康带来更大的风险。

非酒精性脂肪性肝病(NAFLD)在青年人群中的发病率呈上升趋势,该疾病对育龄期妇女具有潜在的影响。目前尚不清楚妊娠期NAFLD是否给孕期或围产期健康带来更大的风险。

 

来自加利福尼亚大学旧金山分校肝病科Sarkar等对美国国家住院患者的出院数据进行加权处理后,评估了妊娠20周后孕妇NAFLD患病率随时间的变化趋势,并与其他慢性肝病(CLD)或无CLD孕妇的结局进行了比较。

研究结果包括早产,产后出血,高血压并发症(先兆子痫,子痫和/或溶血,转氨酶升高和低血小板综合征)以及孕妇或胎儿死亡。通过估算NAFLD历年患病率,并使用线性回归分析时间趋势。对年龄,种族,多胎妊娠和妊娠前糖尿病,肥胖,血脂异常和高血压等因素进行校正后,使用logistic回归分析结局。

研究发现,在18,574,225例孕产妇中,有5,640例患有NAFLD,而115,210例患有其他CLD。NAFLD孕产妇的发病率从2007年的10.5 / 100,000增加了近两倍,2015年达到了28.9 / 100,000(p<0.001)。

NAFLD与其他CLD组及无CLD组相比,妊娠糖尿病(23% vs 7-8%),高血压并发症(16% vs 4%),产后出血(6 vs 3-5%)和早产(9% vs 5-7%)的发生率更高,p值≤0.01。经校正分析后,NAFLD与高血压并发症,早产,产后出血,以及孕产妇死亡相关,但与胎儿死亡无关(p=0.90)。

这项研究表明,在过去的十年中,孕产妇NAFLD的发生率几乎增加了两倍,并且与高血压并发症,产后出血和早产独立相关。NAFLD作为高危的产科疾病应该引起重视,该疾病对孕前咨询和孕期护理具有重要的临床意义。 

摘译自:Sarkar M,Grab J,Dodge J L,et al. Non-alcoholic fatty liver disease in pregnancy is associated with adverse maternal and perinatal outcomes[J] .J Hepatol, 2020, Apr 15.

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    2020-07-20 gwc384
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    2020-07-20 1240394fm61暂无昵称

    非常棒

    0

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