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摘要：
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摘要：目的 探讨总胆汁酸（total bile acid，TBA）升高慢性乙型肝炎（chronic hepatitis B，CHB）孕
妇的围产结局。方法 回顾性分析2016年12月至2018年10月在首都医科大学附属北京地坛医院产检并分娩
的83例CHB孕妇的临床资料，依据入院治疗过程中最高TBA水平分为A组（24例，10 μmol/L ＜ TBA ＜
40 μmol/L），B组（21例，TBA ≥ 40 μmol/L）和C组（38例，0 μmol/L ＜ TBA ≤ 10 μmol/L），比
较各组孕妇围产结局及新生儿结局的差异。结果 A组、B组和C组医源性早产发生率分别为16.67%
（4/24）、42.86%（9/21）、5.26%（2/38），差异有统计学意义（P = 0.002）；自发性早产发生率
分别为4.17%（1/24）、4.16%（1/21）、0.00%（0/38），差异无统计学意义（P = 0.291）。A组、B组、
C组胎儿宫内窘迫及新生儿窒息发生率分别为8.33%（2/24）、19.05%（4/21）、0%（0/38），差
异有统计学意义（P = 0.015）；羊水粪染发生率分别为13.16%（4/24）、16.67%（5/21）、23.81%
（5/38），差异无统计学意义（P = 0.524）。A组、B组、C组产妇足月分娩新生儿体质量分别为
（3273.02 ± 361.39）g、（3202.71 ± 369.69）g、（3373.02 ± 359.79）g，差异无统计学意义（F =
2.885，P = 0.062）。结论 TBA升高CHB孕妇胎儿宫内窘迫、新生儿窒息及医源性早产发生率升高，
但自发性早产发生率未增加。
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Abstract: Objective To investigate the perinatal outcomes of pregnant women with elevated total bile acids
(TBA) and chronic hepatitis B (CHB). Methods The clinical data of 83 pregnant women with CHB in Beijing
Ditan Hospital, Capital Medical University from December 2016 to October 2018 were retrospectively
analyzed. The patients were divided into group A (24 cases, 10 μmol/L ＜ TBA ＜ 40 μmol/L), group B (21 cases,
TBA ≥ 40 μmol/L) and group C (38 cases, 0 μmol/L ＜ TBA ≤ 10 μmol/L) according to the highest levels
of TBA during the treatment. The incidence of adverse perinatal outcomes and neonatal outcomes were
compared. Results The incidence of preterm delivery were 16.67% (4/24), 42.86% (9/21) and 5.26% (2/38)
in group A, group B and group C, respectively, the difference was statistically significant (P = 0.002). The
incidence of spontaneous preterm birth were 4.17% (1/24), 4.16% (1/21) and 0.00% (0/38) in group A, group
B and group C, respectively, the difference was not statistically significant (P = 0.291). The incidence of fetal
distress and neonatal asphyxia were 8.33% (2/24), 19.05% (4/21) and 0% (0/38) in group A, group B and
group C, respectively, the difference was statistically significant (P = 0.015). The incidence of amniotic fluid
meconium pollution were 13.16% (4/24), 16.67% (5/21) and 23.81% (5/38) in group A, group B and group
C, respectively, the difference was not statistically significant (P = 0.524). The birth weight of term infants
were (3273.02 ± 361.39) g, (3202.71 ± 369.69) g and (3373.02 ± 359.79) g in group A, group B and group C,
respectively, the difference was not statistically significant (F = 2.885, P = 0.062). Conclusions The incidence
of preterm delivery, fetal distress and neonatal asphyxia increased, however, the incidence of spontaneous
preterm birth did not increase.
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