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Intrahepatic choles...
Intrahepatic cholestasis of pregnancy and associated adverse pregnancy and fetal outcomes : a 12-year population-based cohort study
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- Shemer, E. Wikström (författare)
- Department of Obstetrics and Gynaecology, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden
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- Marschall, Hanns-Ulrich (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine
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- Ludvigsson, Jonas F., 1969- (författare)
- Karolinska Institutet,Region Örebro län,Dept Med SoClinical Epidemiology Unit, Department of Medicine Solna, Karolinska University Hospital and Institute, Stockholm, Sweden; Department of Paediatrics, Örebro University Hospital, Örebro, Sweden; Clin Epidemiol Unit, Karolinska Univ Hosp & Institute, Stockholm, Sweden; Dept Paediat, Örebro University Hospital, Örebro, Sweden
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- Stephansson, O. (författare)
- Karolinska Institutet
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Ludvigsson, Jf (författare)
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(creator_code:org_t)
- 2013-02-19
- 2013
- Engelska.
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Ingår i: British Journal of Obstetrics and Gynecology. - : Wiley-Blackwell. - 1470-0328 .- 1471-0528. ; 120:6, s. 717-723
- Relaterad länk:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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https://gup.ub.gu.se...
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http://kipublication...
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Abstract
Ämnesord
Stäng
- Objective: To determine the risk for adverse pregnancy and fetal outcomes in intrahepatic cholestasis of pregnancy (ICP).Design: Population-based cohort study.Setting: Swedish Medical Birth Register (MBR) 19972009.Population: A total of 1213668 singleton deliveries.Methods: Linkage of Hospital Discharge Register for exposure (ICP; n=5477) with MBR for covariates.Main outcome measures: Gestational diabetes, pre-eclampsia, prematurity, and stillbirth.Results: Intrahepatic cholestasis (ICP) was diagnosed in 0.320.58% of all pregnancies, with an increasing trend until 2005 (P<0.0001). Compared with women who did not have ICP, women with ICP were more likely to have gestational diabetes (adjusted odds ratio, aOR, 2.81; 95% CI 2.323.41) and pre-eclampsia (aOR 2.62, 95% CI 2.322.78). Women with ICP were also more likely to have spontaneous (aOR 1.60, 95% CI 1.471.93) and iatrogenic (aOR 5.95, 95% CI 5.236.60) preterm delivery, with increased rates of induction of labour (aOR 11.76, 95% CI 11.0411.62). However, this actively managed cohort of ICP cases was not at increased risk of stillbirth (aOR 0.92, 95% CI 0.521.62). Infants in ICP deliveries were more likely to have a low (<7) 5-minute Apgar score (aOR 1.45, 95% CI 1.141.85) and be large for gestational age at birth (aOR 2.27, 95% CI 2.022.55).Conclusions: Over time, a greater proportion of Swedish pregnant women have received a diagnosis of ICP, probably because of an increased awareness of the disorder. Our data confirm an increased risk of preterm delivery, but not of stillbirth, in actively managed ICP. The high rates of gestational diabetes and pre-eclampsia are new findings, and need to be considered in the management of ICP pregnancies.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Reproduktionsmedicin och gynekologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Obstetrics, Gynaecology and Reproductive Medicine (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Gastroenterologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Gastroenterology and Hepatology (hsv//eng)
Nyckelord
- Bile acids
- gestational diabetes
- intrahepatic cholestasis of pregnancy
- intrauterine fetal death
- obstetric cholestasis
- pre-eclampsia
- stillbirth
- ursodeoxycholic acid
- Bile acids;gestational diabetes;intrahepatic cholestasis of pregnancy;intrauterine fetal death;obstetric cholestasis;pre-eclampsia;stillbirth;ursodeoxycholic acid
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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