Abstract：
BACKGROUND: Immigrants with inflammatory bowel disease (IBD) may have increased healthcare utilization during pregnancy compared with non-immigrants, although this remains to be confirmed. We aimed to characterize this between these groups.
METHODS: We accessed administrative databases to identify women (aged 18-55 years) with IBD with a singleton pregnancy between 2003 and 2018. Immigration status was defined as recent (<5 years of the date of conception), remote (≥5 years since the date of conception), and none. Differences in ambulatory, emergency department, hospitalization, endoscopic, and prenatal visits during 12 months preconception, pregnancy, and 12 months postpartum were characterized. Region of immigration origin was ascertained. Multivariable negative binomial regression was performed for adjusted incidence rate ratios (aIRRs) with 95% confidence intervals (CIs).
RESULTS: A total of 8,880 pregnancies were included, 8,304 in non-immigrants, 96 in recent immigrants, 480 in remote immigrants. Compared with non-immigrants, recent immigrants had the highest rates of IBD-specific ambulatory visits during preconception (aIRR 3.06, 95% CI 1.93-4.85), pregnancy (aIRR 2.15, 95% CI 1.35-3.42), and postpartum (aIRR 2.21, 1.37-3.57) and the highest rates of endoscopy visits during preconception (aIRR 2.69, 95% CI 1.64-4.41) and postpartum (aIRR 2.01, 95% CI 1.09-3.70). There were no differences in emergency department and hospitalization visits between groups, although those arriving from the Americas were the most likely to be hospitalized for any reason. All immigrants with IBD were less likely to have a first trimester prenatal visit.
CONCLUSIONS: Recent immigrants were more likely to have IBD-specific ambulatory care but less likely to receive adequate prenatal care during pregnancy.
METHODS: We accessed administrative databases to identify women (aged 18-55 years) with IBD with a singleton pregnancy between 2003 and 2018. Immigration status was defined as recent (<5 years of the date of conception), remote (≥5 years since the date of conception), and none. Differences in ambulatory, emergency department, hospitalization, endoscopic, and prenatal visits during 12 months preconception, pregnancy, and 12 months postpartum were characterized. Region of immigration origin was ascertained. Multivariable negative binomial regression was performed for adjusted incidence rate ratios (aIRRs) with 95% confidence intervals (CIs).
RESULTS: A total of 8,880 pregnancies were included, 8,304 in non-immigrants, 96 in recent immigrants, 480 in remote immigrants. Compared with non-immigrants, recent immigrants had the highest rates of IBD-specific ambulatory visits during preconception (aIRR 3.06, 95% CI 1.93-4.85), pregnancy (aIRR 2.15, 95% CI 1.35-3.42), and postpartum (aIRR 2.21, 1.37-3.57) and the highest rates of endoscopy visits during preconception (aIRR 2.69, 95% CI 1.64-4.41) and postpartum (aIRR 2.01, 95% CI 1.09-3.70). There were no differences in emergency department and hospitalization visits between groups, although those arriving from the Americas were the most likely to be hospitalized for any reason. All immigrants with IBD were less likely to have a first trimester prenatal visit.
CONCLUSIONS: Recent immigrants were more likely to have IBD-specific ambulatory care but less likely to receive adequate prenatal care during pregnancy.
摘要：
背景：与非移民相比，患有炎症性肠病（IBD）的移民在怀孕期间可能会增加医疗保健利用率，尽管这还有待证实。我们的目的是在这些群体之间描述这一点。
方法：我们访问了管理数据库，以确定2003年至2018年间单胎妊娠的IBD女性（年龄18-55岁）。移民身份被定义为最近(<5年的概念日期),远程（自受孕之日起≥5年），和没有。在门诊的差异，急诊科,住院治疗,内窥镜,怀孕前12个月的产前检查，怀孕,以产后12个月为特征。确定了移民来源地区。对调整后的发病率比率（aIRRs）进行多变量负二项回归，95%置信区间（CIs）。
结果：共包括8,880例妊娠，非移民8304人，96在最近的移民中，480名偏远移民。与非移民相比，最近的移民在孕前期间的IBD特定门诊就诊率最高（aIRR3.06，95％CI1.93-4.85），怀孕（aIRR2.15，95%CI1.35-3.42），和产后（aIRR2.21，1.37-3.57）以及在孕前（aIRR2.69，95％CI1.64-4.41）和产后（aIRR2.01，95％CI1.09-3.70）期间的内窥镜检查率最高。两组在急诊科和住院访视方面没有差异，尽管来自美洲的人最有可能因任何原因住院。所有患有IBD的移民不太可能进行妊娠早期产前检查。
结论：最近的移民更有可能接受IBD特定的门诊护理，但在怀孕期间接受适当的产前护理的可能性较小。
方法：我们访问了管理数据库，以确定2003年至2018年间单胎妊娠的IBD女性（年龄18-55岁）。移民身份被定义为最近(<5年的概念日期),远程（自受孕之日起≥5年），和没有。在门诊的差异，急诊科,住院治疗,内窥镜,怀孕前12个月的产前检查，怀孕,以产后12个月为特征。确定了移民来源地区。对调整后的发病率比率（aIRRs）进行多变量负二项回归，95%置信区间（CIs）。
结果：共包括8,880例妊娠，非移民8304人，96在最近的移民中，480名偏远移民。与非移民相比，最近的移民在孕前期间的IBD特定门诊就诊率最高（aIRR3.06，95％CI1.93-4.85），怀孕（aIRR2.15，95%CI1.35-3.42），和产后（aIRR2.21，1.37-3.57）以及在孕前（aIRR2.69，95％CI1.64-4.41）和产后（aIRR2.01，95％CI1.09-3.70）期间的内窥镜检查率最高。两组在急诊科和住院访视方面没有差异，尽管来自美洲的人最有可能因任何原因住院。所有患有IBD的移民不太可能进行妊娠早期产前检查。
结论：最近的移民更有可能接受IBD特定的门诊护理，但在怀孕期间接受适当的产前护理的可能性较小。
