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J Hepatology:妊娠期非酒精性脂肪肝与围产期不良结局相关

2020-10-07 MedSci原创 MedSci原创

非酒精性脂肪肝疾病(NAFLD)是美国最常见的引起慢性肝病(CLD)的疾病,单纯性肝脂肪变性以及肝细胞的损伤和纤维化,均称为非酒精性脂肪性肝炎.

        非酒精性脂肪肝疾病(NAFLD)是美国最常见的引起慢性肝病(CLD)的疾病,单纯性肝脂肪变性以及肝细胞的损伤和纤维化,均称为非酒精性脂肪性肝炎(NASH)。在美国,育龄妇女也是NASH的高发人群,怀孕本身是一个胰岛素相对抵抗的状态和肥胖并发机会增加的时期。妊娠期间患有NAFLD是否会对母亲或围产期健康更大的风险尚不清楚。因此,本项研究就旨在进行这方面的探究。

 

 

        研究人员评估了美国健康数据库中的妊娠20周后孕妇NAFLD的时间趋势,并将其与其他慢性肝病(CLD)或无CLD的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,肝酶升高和低血小板综合征)以及孕产妇或胎儿死亡情况。

 

 

        在18574225例怀孕妇女中,有5640例患有NAFLD,而115210例患有其他非NAFLD的慢性肝病(CLD)。患有NAFLD的怀孕几率从2007年的10.5 / 100000怀孕上升至2015年的28.9 / 100,000( p <0.001),增加了近两倍。与其他组相比,妊娠期间患有NAFLD的患者更容易发生妊娠糖尿病(8%VS 23%),高血压并发症(4%VS16%),产后出血(5% VS 6%)。和早产(7%VS 9%), p≤0.01。经校正分析,与无CLD相比,NAFLD与高血压并发症,早产,产后出血与孕产妇死亡相关。

 

        研究人员最后指出在过去的十年中,怀孕期间NAFLD的患病率几乎增加了两倍,并且与高血压并发症,产后出血和早产独立相关。

 

 

原始出处 :

Monika Sarkar. Et al. Non-alcoholic fatty liver disease in pregnancy is associated with adverse maternal and perinatal outcomes. Journal of Hepatology.2020.

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    2021-04-30 MedSciZeng

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    2020-10-09 gwc384

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