Pre-conception status, obstetric outcome and use of medications during pregnancy of systemic lupus erythematosus (SLE), rheumatoid arthritis (RA) and inflammatory bowel disease (IBD) in Japan: Multi-center retrospective descriptive study
Pre-conception status, obstetric outcome and use of medications during pregnancy of systemic lupus erythematosus (SLE), rheumatoid arthritis (RA) and inflammatory bowel disease (IBD) in Japan: Multi-center retrospective descriptive study
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DOI：
10.1080/14397595.2019.1661592
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发表时间：
2019-09-24
影响因子：
2.2
通讯作者：
Age, Minist Hlth Labour Welfare Working Grp Guideline Treatment Rheumatoid Arthr
中科院分区：
文献类型：
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作者：
Tsuda, Sayaka;Sameshima, Azusa;Age, Minist Hlth Labour Welfare Working Grp Guideline Treatment Rheumatoid Arthr
目的：描述系统性红斑狼疮（SLE）、类风湿性关节炎（RA）、克罗恩病（CD）和溃疡性结肠炎（UC）的孕前状态、妊娠结局和药物治疗流行率。研究方法：日本产妇胎儿重症监护室网络医院的基于电子邮件的问卷调查，询问SLE、RA、CD和UC合并妊娠的患病率和临床特征，持续2年。结果：69，810例分娩中SLE、RA、CD和UC分别为184例、139例、27例和178例。计划怀孕的不到一半。SLE、RA和UC患者的辅助生殖技术（ART）妊娠率高于普通人群（11.4、23.0和7.4 vs 5.1%，p <0.001）。SLE患者中早产、先兆子痫和胎儿生长受限（FGR）的发生率高于一般人群（39.4 vs. 5.6% p <0.001，15.0 vs. 6.0% p <0.001，12.9 vs. 4.2% p <0.001）。RA和UC的早产患病率（27.5 vs. 5.6% p < .001，11.3 vs. 5.6% p < .05）和CD的FGR患病率（28.6 vs. 4.2% p < .001）也高于一般人群。结论：妊娠合并SLE、RA、CD和UC是产科不良结局的高危因素。SLE、RA和UC妊娠中的高ART率需要孕前咨询。
Objective: To describe the pre-conception status, pregnancy outcomes, and medication prevalence in systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), Crohn's disease (CD), and ulcerative colitis (UC). Methods: E-mail-based questionnaire survey for the Japan Maternal Fetal Intensive Care Unit Network hospitals inquiring prevalence and clinical features of SLE, RA, CD and UC complicated pregnancies for 2 years. Results: The number of SLE, RA, CD and UC among 69,810 deliveries was 184, 139, 27 and 178, respectively. Less than half of pregnancies were planned. Assisted reproductive technology (ART) pregnancy rates were higher in SLE, RA and UC than in the general population (11.4, 23.0 and 7.4 vs 5.1%, p < .001 each). Preterm delivery, preeclampsia, and fetal growth restriction (FGR) were more frequent in SLE than in the general population (39.4 vs. 5.6% p < .001, 15.0 vs. 6.0% p < .001, 12.9 vs 4.2% p < .001). Prevalence of preterm delivery in RA and UC (27.5 vs. 5.6% p < .001, 11.3 vs. 5.6% p < .05) and FGR in CD (28.6 vs. 4.2% p < .001) was also higher than that in the general population. Conclusion: SLE, RA, CD, and UC complicated pregnancies were at high risks of obstetric adverse outcome. High ART rates necessitate pre-conception counseling in SLE, RA, and UC pregnancies.