中重度炎症性肠炎女性需预防不良妊娠结局
创作:尹小甜 审核:Epi汪 2020年04月24日
  • 纳入韩国国家卫生数据库中炎症性肠炎(IBD)女性数据,其中2058例(25.7%)随访期内怀孕,比例低于非IBD女性(32.3%);
  • 克罗恩氏病女性剖宫产率(46.5% vs 38.8%)、胎儿宫内迟缓发生率(3.0% vs 1.0%)比非IBD女性更高;
  • 中重度IBD女性相比于非IBD女性活产率(65.0% vs 69.9%)更低,而自然流产(14.9% vs 11.9%)、剖宫产(46.4%vs 38.8%)及宫内生长受限(3.4% vs 1.0%)率均更高;
  • 轻度IBD女性与非IBD女性妊娠结局无统计学差异。
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Epi汪
本研究通过国家登记数据分析,发现患有中/重度炎症性肠炎的女性在未来妊娠结局中活产率更低,而自然流产率更高。其中的机制有待进一步研究。但提示我们针对这部分女性,在孕期体检时应该更加重视和注意防范不良妊娠结局风险。
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Pregnancy outcomes in women with inflammatory bowel disease: A 10‐year nationwide population‐based cohort study

炎症性肠病女性妊娠结局:一项10年国家级人群队列研究

10.1111/apt.15654

2020-04-07, Article

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Background: Data relating to the association between inflammatory bowel disease (IBD) and pregnancy outcomes are lacking in Korea.
Methods: A nationwide population study was performed using the Korean National Health Insurance claims database. A total of 2058 women with IBD consisting of ulcerative colitis (UC, n = 1469) and Crohn's disease (CD, n = 589) were pregnant between 2007 and 2016. We compared their incidence of pregnancy outcomes with 20 580 age-matched controls without IBD. We also stratified the patients into those with quiescent to mild and moderate to severe IBD and compared the outcomes between them.
Results: The pregnancy rate of women with IBD was lower than that of women without (25.7% vs 32.3%, P < 0.001). Caesarean section (46.5% vs 38.8%, odds ratio [OR] 1.43, 95% confidence interval [CI]: 1.17-1.75), and intrauterine growth retardation (IUGR) (3.0% vs 1.0%, OR 2.89, 95% CI: 1.59-5.26) were increased in CD patients than the controls. In regards to disease severity, there were no significant differences in pregnancy outcomes between patients with quiescent to mild IBD and the controls. However, the live birth rate of patients with moderate to severe IBD was lower than that of the controls (65.0% vs 69.9%, OR 0.79, 95%CI: 0.66-0.94). In addition, moderate to severe IBD was significantly associated with spontaneous abortion (14.9% vs 11.9%, OR 1.33, 95% CI: 1.04-1.68), caesarean section (46.4% vs 38.8%, OR 1.41, 95% CI: 1.14-1.74) and IUGR (3.4% vs 1.0%, OR 3.20, 95% CI: 1.75-5.84).
Conclusions: With the exception of moderate to severe disease, the incidences of adverse pregnancy outcomes in women with IBD are similar to that of the general population.

First Authors:
Han H Lee

Correspondence Authors:
Bo-In Lee,Kang-Moon Lee

All Authors:
Han H Lee,Jung M Bae,Bo-In Lee,Kang-Moon Lee,Jeong H Wie,Jin S Kim,Young-Seok Cho,Sung-Ae Jung,Sang W Kim,Hwang Choi,Myung-Gyu Choi

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