A nomogram for predicting the risk of preeclampsia in women with intrahepatic cholestasis of pregnancy based on prenatal monitoring time: a multicenter retrospective cohort study

作者全名："Cai, Qin-Yu; Li, Zhuo-Hang; Deng, Bei-Ning; Luo, Xin; Lan, Xia; Chen, Ya; Liang, Li-Fang; Liu, Chen-Yang; Liu, Tai-Hang; Wang, Ying-Xiong; Wang, Lan"

作者地址："[Cai, Qin-Yu; Li, Zhuo-Hang; Deng, Bei-Ning; Lan, Xia; Chen, Ya; Liang, Li-Fang; Wang, Lan] Chongqing Med Univ, Dept Obstet, Women & Childrens Hosp, Chongqing, Peoples R China; [Cai, Qin-Yu; Deng, Bei-Ning; Luo, Xin; Liang, Li-Fang; Liu, Chen-Yang; Liu, Tai-Hang; Wang, Ying-Xiong] Chongqing Med Univ, Joint Int Res Lab Reprod & Dev, Chongqing, Peoples R China; [Li, Zhuo-Hang] Tradit Chinese Med Hosp Yaan, Med Lab Dept, Yaan, Sichuan, Peoples R China; [Luo, Xin] Chongqing Med Univ, Dept Obstet, Affiliated Hosp 1, Chongqing, Peoples R China; [Wang, Ying-Xiong; Wang, Lan] Chongqing Med Univ, Women & Childrens Hosp, 120 Longshan Rd, Chongqing 401147, Peoples R China"

通信作者："Wang, YX; Wang, L (通讯作者)，Chongqing Med Univ, Women & Childrens Hosp, 120 Longshan Rd, Chongqing 401147, Peoples R China."

来源：JOURNAL OF HYPERTENSION

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001156951100014

JCR分区：Q1

影响因子：4.9

年份：2024

卷号：42

期号：1

开始页：143

结束页：152

文献类型：Article

关键词：intrahepatic cholestasis of pregnancy; monitoring times; nomogram; preeclampsia; ursodeoxycholic acid

摘要："Background and aims:Intrahepatic cholestasis of pregnancy (ICP) is a special liver disease during pregnancy, characterized by abnormal bile acid metabolism. However, there is no consensus on how to group women with ICP based on the time of diagnosis worldwide. This study aimed to adopt a new grouping model of women with ICP, and the time from diagnosis to delivery was defined as the monitoring period.Methods:This retrospective real-world data study was conducted across multiple centers and included 3172 women with ICP. The study first evaluated the significant difference in medication and nonmedication during different monitoring times. The least absolute shrinkage and selection operator (LASSO) model was then used to screen nine risk factors based on the predictors. The model's discrimination, clinical usefulness, and calibration were assessed using the area under the receiver operating characteristic (ROC) curve, decision curve, and calibration analysis.Results:The incidence of preeclampsia risk in ICP patients without drug intervention increased with the extension of the monitoring period. However, the risk of preeclampsia decreased in ICP patients treated with ursodeoxycholic acid. A predictive nomogram and risk score model was developed based on nine risk factors. The area under the ROC curve of the nomogram was 0.765 [95% confidence interval (CI): 0.724-0.807] and 0.812 (95% CI: 0.736-0.889) for the validation cohort.Conclusions:This study found that a longer ICP monitoring period could lead to adverse pregnancy outcomes in the absence of drug intervention, especially preeclampsia. A predictive nomogram and risk score model was developed to better manage ICP patients, maintain pregnancy to term delivery, and minimize the risk of severe adverse maternal and fetal outcomes."

基金机构："National Natural Science Foundation of China [82271707]; Program for Youth Innovation in Future Medicine, Chongqing Medical University [W0068]"

基金资助正文："This study was supported by the National Natural Science Foundation of China (Grant number 82271707) and the Program for Youth Innovation in Future Medicine, Chongqing Medical University (Grant number W0068)."