关键词: 胆汁淤积, 肝内, 妊娠并发症, 微RNAs, 胰岛素样生长因子结合蛋白质3, 妊娠结局

Abstract: Objective：To investigate the expressions of miR-21 and insulin-like growth factor binding protein-3 (IGFBP-3) in serum of patients with intrahepatic cholestasis of pregnancy (ICP) and their relationships with perinatal fetal outcomes. Methods: 62 ICP patients admitted to Sichuan Provincial Hospital for Women and Children were selected as the study group, and 62 healthy pregnant women with physical examination were selected as the control group. We collected their antepartum venous blood, detected the relative expression of miR-21 and IGFBP-3 in serum by real-time fluorescent quantitative polymerase chain reaction (qRT-PCR) , and compared the correlation between miR-21 and IGFBP-3 and perinatal outcome. Results: The level of serum miR-21 in the study group was higher than that in the control group, and the level of IGFBP-3 in the study group was lower than that in the control group, and the difference was statistically significant (both P＜0.05). There was a negative correlation between the expression of miR-21 and IGFBP-3 in ICP patients (r=-783, P=0.000). The incidences of premature delivery, cesarean section and meconium stained of amniotic fluid in patients with miR-21 high expression were higher than those in patients with miR-21 low expression, and the gestational age of delivery and birth weight of neonates were lower than those of miR-21 low expression group, difference of which was statistically significant (all P＜0.05). There was no significant difference in the incidence of neonatal asphyxia and fetal death between the two groups (all P＞0.05). The incidences of premature delivery, cesarean section and meconium stained of amniotic fluid in IGFBP-3 low expression group were higher than those in IGFBP-3 high expression group, the gestational weeks and birth weight of neonates were lower than those of IGFBP-3 high expression group, and the difference was statistically significant (all P＜0.05). There was no significant difference in the incidences of neonatal asphyxia and fetal death between the two groups (all P＞0.05). Conclusions: The high expression of miR-21 and the low expression of IGFBP-3 in serum of ICP patients were negatively correlated with each other. The incidence of perinatal adverse outcome was higher in ICP patients with high expression of miR-21 and low expression of IGFBP-3, which should be paid attention to in clinic.

Key words: Cholestasis, intrahepatic, Pregnancy complications, MicroRNAs, Insulin-like growth factor binding protein 3, Pregnancy outcome