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Common causes of liver abnormalities during pregnancy in Chinese women and their impact on pregnancy outcomes: A systematic review and metaanalysis

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Journal Title:
World Chinese Journal of Digestology
Key Word:
妊娠期肝异常;病因;妊娠结局;Meta分析;Liver abnormality during pregnancy;Pathogeny;Pregnancy outcome;Meta-analysis

Abstract´╝Ü AIM To analyze the common causes of liver abnormalities during pregnancy in Chinese women and their effects on maternal and fetal outcomes.METHODS The CNKI, WANFANG database and VIP database were searched to collect all the literature on liver abnormalities during pregnancy published in Chinese during the past 20 years. The data were analyzed using R software and Stata software. RESULTS Thirty-seven studies were included, with a total of 8367 cases. The results of meta-analysis showed that the common causes of liver abnormalities during pregnancy in Chinese women included hepatitis (39%; 95%CI: 30%-48%), pregnancy induced hypertension syndrome (17%; 10%-25%), intrahepatic cholestasis of pregnancy (ICP) (17%; 14%-19%), acute fatty liver of pregnancy (3%; 2%-4%), hyperemesis gravidarum (8%; 6%-11%), and HELLP syndrome (3%; 1%-5%). With regard topregnancy outcomes with liver abnormalities caused by hepatitis, the probabilities of premature delivery, cesarean section, postpartum hemorrhage, fetal distress and perinatal death were 20%, 35%, 15%, 26% and 16%, respectively; the corresponding probabilities were 21%, 62%, 16%, 40% and 15% for pregnancy induced hypertension syndrome, and 36%, 70%, 15%, 35% and 16% for ICP. Abnormal liver function during pregnancy was associated with adverse pregnancy outcomes, and the OR values (95%CIs) were as follows: premature delivery, 4.48 (3.89-6.60); cesarean section, 3.75 (3.28-4.29); postpartum hemorrhage, 5.36 (4.07-7.05); fetal distress, 3.78 (3.16-4.53); perinatal death, 6.39 (3.27-12.49); pregnancy induced hypertension, 4.67 (3.44-6.35); asphyxia neonatorum, 3.07 (2.18-4.32).CONCLUSION Hepatitis is the primary cause of abnormal liver function during pregnancy, followed by pregnancy induced hypertension syndrome and ICP. All of these increase the risk of mothers and infants during pregnancy and delivery.

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