Analysis of the value of maternal and fetal bile acid levels in intrahepatic cholestasis in pregnancy in the assessment of fetal cardiac insufficiency
Objective To investigate the application of maternal and fetal total serum bile acid(TSBA)levels in intrahepatic cholestasis of pregnancy(ICP)in assessing neonatal cardiac insufficiency.Methods 36 ICP patients(15 severe and 21 mild)and 15 matched controls who attended Hunan Provincial People's Hospital between January 2021 and January 2022 were selected as study subjects.TSBA and N-terminal pro-brain natriuretic peptide(NT-proBNP),a marker of ventricular dysfunction,were measured in umbilical vein serum by ultra-performance liquid chromatography tandem mass spectrometry(UPLC-MS/MS).Fetal electrocardiograms were obtained,and PR interval length and heart rate variability(HRV)parameters were measured and analyzed.Results Compared with the control group,the gestational age and fetal birth weight of ICP patients at delivery were reduced(H=7.594 and 95.603,respectively,P＜0.05),and the number of induced labor and natural vaginal delivery were increased,with statistically significant differences(PFisher＜0.05).There were statistical differences in the peak concentration of maternal and fetal TSBA and the concentration of fetal NT-proBNP at delivery among the three groups,in which each index was greater in patients with severe ICP than in the control group,in which each index was greater in atients with Severe IC than in the contrl group.(H=75.062,8.093 and 4.266,respectively,P＜0.05).There were statistical differences in the length of PR interval and standard deviation of normal-to-normal intervals(SDNN)value of fetus in active sleep state among the three groups,in which each index was greater in patients with severe ICP than in the control group(H=4.913 and 4.520,respectively,P＜0.05).Correlation analysis showed that there was a positive correlation between fetal NT-proBNP and the hydrophobicity index(HI)of fetal TSBA(r=0.37 and 0.54,respectively,P＜0.05).There was a positive correlation between maternal TSBA concentration and fetal PR interval length and SDNN value(r=0.49 and 0.34,respectively,P＜0.05).Conclusion Elevated fetal and maternal serum bile acid concentrations in ICP are associated with an abnormal fetal cardiac phenotype characterized by increased NT-proBNP concentration,PR interval length,and HRV.
intrahepatic cholestasis of pregnancybile acidsneonatescardiac insufficiency
万方数据
维普
