OBJECTIVE: To determine the impact of disease activity during pregnancy on the obstetric prognosis of women with IBD.
METHODS: Gastroenterological and obstetric data were collected for patients for all consecutive patients with IBD and pregnancy followed up at Amiens University Hospital (Amiens, France) between 2007 and 2021. Obstetrics outcome of patients with and without active disease were compared.
RESULTS: One hundred patients were included (81 with Crohn\'s Disease for 198 pregnancies, 19 with Ulcerative Colitis for 37 pregnancies). Patients with active IBD (21 patients, 24 pregnancies) were more likely to be admitted to hospital during pregnancy (66.6, vs. 5.2% in the inactive IBD group; p < 0.001), to give birth prematurely (mean term: 36.77 weeks of amenorrhoea (WA) vs. 38.7 WA, respectively; p = 0.02) and to experience very premature delivery (before 32 WA: 12.5 vs. 1.4%, respectively; p = 0.02). Patients with active disease had a shorter term at birth (38.4 WA, vs. 39.8 WA in the inactive disease group; p < 0.0001), a lower birth weight (2707 g vs. 3129 g, respectively; p = 0.01) and higher caesarean section rate (54.2 vs. 16.9%, respectively; p = 0.03).
CONCLUSIONS: Women with IBD patients are at risk of pregnancy related complications, especially when IBD is active. Controlling disease activity at conception and close monitoring of the pregnancy is essential to improve both gastroenterological and obstetric outcome.
目的:确定妊娠期疾病活动对IBD妇女产科预后的影响。
方法:在亚眠大学医院(亚眠,法国)在2007年至2021年之间。比较有和没有活动性疾病的患者的产科结局。
结果:纳入了100例患者(81例克罗恩病,198例妊娠,19例溃疡性结肠炎37例妊娠)。活动性IBD患者(21例,24次怀孕)更有可能在怀孕期间入院(66.6,vs.非活动IBD组5.2%;p<0.001),早产(平均期限:闭经36.77周(WA)与38.7WA,分别;p=0.02)和经历非常过早的分娩(32WA之前:12.5vs.1.4%,分别为;p=0.02)。患有活动性疾病的患者在出生时的足月较短(38.4WA,vs.非活动疾病组的39.8WA;p<0.0001),较低的出生体重(2707克vs.3129g,分别为;p=0.01)和更高的剖腹产率(54.2vs.16.9%,分别为;p=0.03)。
结论:女性IBD患者有妊娠相关并发症的风险,特别是当IBD活跃时。控制受孕时的疾病活动和密切监测妊娠对改善胃肠和产科结局至关重要。