Global and regional incidence of intrahepatic cholestasis of pregnancy: a systematic review and meta-analysis.

IF 8.3 1区医学 Q1 MEDICINE, GENERAL & INTERNAL BMC Medicine Pub Date : 2025-02-28 DOI:10.1186/s12916-025-03935-0

Ali Jamshidi Kerachi, Mohammad Amin Shahlaee, Pardis Habibi, Niloofar Dehdari Ebrahimi, Moein Ala, Alireza Sadeghi

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Abstract

Background: Intrahepatic cholestasis of pregnancy (ICP) can be a source of significant distress for both pregnant women and the fetus, impairing the quality of life and well-being of pregnant women, leading to psychological disorders among pregnant women with severe or recurrent ICP, and causing life-threatening complications among fetuses. Regrettably, our current understanding of ICP globally is limited, lacking a comprehensive estimation of its incidence. Therefore, in this systematic review and meta-analysis, we aimed to investigate the global and regional incidence of ICP and identify factors that account for its variety across studies.

Methods: A comprehensive search strategy was implemented across PubMed, Scopus, and Web of Science databases. To stabilize the variance, the Freeman-Tukey double arcsine transformation was employed. Subgroup analyses were conducted based on continent, publication type, study design and timing, regional classifications, developmental status, and World Bank income grouping. A multivariate meta-regression analysis was performed to estimate the effects of the continuous moderators on the effect size.

Results: A total of 42,972,872 pregnant women were analyzed from 302 studies. The overall pooled incidence [95% confidence interval] of ICP was 2.9% [2.5, 3.3]. Studies with larger sample sizes tended to provide significantly lower estimates of ICP incidence: 1.6% [1.3, 2] vs 4.7% [3.9, 5.5]. Asia had the highest incidence of ICP among the continents, whereas Oceania had the lowest. Countries that were classified as developed and with higher income had a lower incidence of ICP than those classified as developing and low and middle income.

Conclusions: The findings of this study will provide valuable insights into the current knowledge regarding the association of the quality of public health and socioeconomic variations with the incidence of ICP on a global scale.

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妊娠期肝内胆汁淤积症的全球和地区发病率：系统回顾和荟萃分析。

背景：妊娠肝内胆汁淤积症（ICP）对孕妇和胎儿都是一种严重的困扰，影响孕妇的生活质量和健康，导致严重或复发性ICP孕妇的心理障碍，并导致危及生命的胎儿并发症。遗憾的是，我们目前对全球ICP的了解是有限的，缺乏对其发病率的全面估计。因此，在本系统综述和荟萃分析中，我们旨在调查ICP的全球和地区发病率，并确定其在研究中的多样性因素。方法：在PubMed、Scopus和Web of Science数据库中实施综合搜索策略。为了稳定方差，采用Freeman-Tukey双反正弦变换。根据大陆、出版物类型、研究设计和时间、地区分类、发展状况和世界银行收入分组进行了分组分析。采用多元元回归分析来估计连续调节因子对效应量的影响。结果：302项研究共分析了42972872名孕妇。ICP的总合并发病率[95%可信区间]为2.9%[2.5,3.3]。样本量较大的研究往往提供明显较低的ICP发生率估计值：1.6%[1.3,2]对4.7%[3.9,5.5]。在各大洲中，亚洲的ICP发病率最高，而大洋洲的发病率最低。被划分为发达国家和高收入国家的ICP发病率低于被划分为发展中国家和中低收入国家。结论：本研究的结果将为目前关于全球范围内公共卫生质量和社会经济变化与ICP发病率之间关系的知识提供有价值的见解。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

BMC Medicine 医学-医学：内科

CiteScore

13.10

自引率

1.10%

发文量

435

审稿时长

4-8 weeks

期刊介绍： BMC Medicine is an open access, transparent peer-reviewed general medical journal. It is the flagship journal of the BMC series and publishes outstanding and influential research in various areas including clinical practice, translational medicine, medical and health advances, public health, global health, policy, and general topics of interest to the biomedical and sociomedical professional communities. In addition to research articles, the journal also publishes stimulating debates, reviews, unique forum articles, and concise tutorials. All articles published in BMC Medicine are included in various databases such as Biological Abstracts, BIOSIS, CAS, Citebase, Current contents, DOAJ, Embase, MEDLINE, PubMed, Science Citation Index Expanded, OAIster, SCImago, Scopus, SOCOLAR, and Zetoc.