Pregnancy outcomes in women with inflammatory bowel disease: A large community-based study from Northern California
Pregnancy outcomes in women with inflammatory bowel disease: A large community-based study from Northern California
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DOI：
10.1053/j.gastro.2007.07.019
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发表时间：
2007-10-01
期刊：
影响因子：
29.4
通讯作者：
Corley, Douglas A.
中科院分区：
文献类型：
--
作者：
Mahadevan, Uma;Sandborn, William J.;Corley, Douglas A.
背景与目的：本研究的目的是确定患有炎症性肠病(IBD)和不患有炎症性肠病(IBD)的妇女的妊娠结局是否不同，并确定哪些危险因素会对结局产生不利影响。方法：我们对1995年至2002年间北加州凯撒永久会员中的所有孕妇进行了一项队列研究。我们提取了患有IBD的妇女的所有妊娠记录(暴露队列)和年龄匹配的非IBD妇女的怀孕随机样本(非暴露队列)，并评估了自然流产、妊娠并发症和不良新生儿事件的危险因素。结果：共有461名患有IBD的孕妇与493名未接触IBD的孕妇匹配。患有IBD的女性更有可能患有。不良妊娠结局(优势比1.65；95%可信区间1.09-2.48)、不良妊娠结局(优势比1.54；95%可信区间1.00-2.38)或妊娠并发症(优势比1.78；95%可信区间1.13-2.81)；然而，两组新生儿不良结局差异无统计学意义(优势比1.89；95%可信区间0.98-3.69)。不良结局的独立预测因素包括炎症性肠病的诊断、炎症性肠病的手术史和非高加索种族。疾病的严重程度和药物治疗与不良结果无关。结论：患有IBD的妇女更有可能有与怀孕有关的不良结局。在大量的非转诊人群中，疾病活动和药物治疗并不能预测不良结果。
Background & Aims: The aim of this study was to determine whether pregnancy outcomes differ between women with and without inflammatory bowel disease (IBD) and to determine what risk factors adversely affect outcomes. Methods: We conducted a cohort study of all pregnant women within the Northern California Kaiser Permanente membership between the years 1995 and 2002. We abstracted the records of all pregnancies in women with IBD (exposed cohort) and a random sample of pregnancies from age-matched women without IBD (unexposed cohort) and evaluated risk factors for spontaneous abortion, complications of pregnancy, and adverse newborn events. Results: A total of 461 pregnant women with IBD were matched to 493 unexposed pregnant women. Women with IBD were more likely to have an. adverse conception outcome (odds ratio, 1.65; 95% confidence interval, 1.09-2.48), an adverse pregnancy outcome (odds ratio, 1.54; 95% confidence interval, 1.00-2.38), or a pregnancy complication (odds ratio, 1.78; 95% confidence interval, 1.13-2.81); however, the difference between the 2 groups in adverse newborn outcomes was not statistically significant (odds ratio, 1.89; 95% confidence interval, 0.98-3.69). Independent predictors of an adverse outcome included a diagnosis of IBD, a history of surgery for IBD, and non-Caucasian ethnicity. Severity of disease and medical treatments were not associated with an adverse outcome. Conclusions: Women with IBD are more likely to have an adverse outcome related to pregnancy. Disease activity and medical treatment did not predict adverse outcomes in a large, nonreferral population.