Clinical characteristics of pregnancy complicated with inflammatory bowel disease
10.19723/j.issn.1671-167X.2024.02.009
- VernacularTitle:妊娠合并炎症性肠病的临床特点
- Author:
Huichao MA
1
;
Jun LI
;
Yongqing WANG
Author Information
1. 北京大学第三医院妇产科,国家妇产疾病临床医学研究中心,辅助生殖教育部重点实验室,生殖内分泌与辅助生殖技术北京市重点实验室,北京 100191;河北省宁晋县医院妇产科,河北邢台 055550
- Keywords:
Inflammatory bowel diseases;
Pregnancy outcome;
Disease management;
Pregnancy nutri-tion
- From:
Journal of Peking University(Health Sciences)
2024;56(2):260-266
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the clinical characteristics of patients with inflammatory bowel disea-ses(IBD)in pre-pregnancy,pregancy and loctation.Methods:The clinical data of pregnancy compli-cated with IBD in Department of Obstetrics and Gynecology of Peking University Third Hospital and deli-very from September 2011 to June 2022 were collected.The clinical characteristics of the patients were analyzed retrospectively.According to the state of diseases during pre-pregnancy,pregnancy and lactation,the patients were divided into active and remission group,and the two groups were compared interms of pre-pregnancy counseling,nutritional status,pregnancy and delivery complications,gestational week,mode of delivery,and neonatal outcome.Results:A total of 33 pregnant women with IBD were included in this study,of which 7 delivered a second child,for a total of 40 deliveries,with 36 natural pregnan-cies(90.0%)and 4 assisted reproductions(10.0%).Among the 40 cases,21 cases(52.5%)were sustained in remission in pre-pregnancy,pregnancy and lactation,and 19 cases(47.5%)in disease ac-tivity,of which 8 cases(42.1%)were due to self-withdrawal of drugs or failure to take medicine regu-larly.Compared with the activity group,the disease remission group had a higher rate of pre-pregnancy counseling(57.1%vs.15.8%,P=0.010),and higher levels of hemoglobin[(112.67±8.53)g/L vs.(102.84±5.23)g/L,P<0.001],serum total protein[(66.58±6.34)g/L vs.(60.83±6.25)g/L,P=0.006],serum albumin[36.4(35.1,38.3)g/L vs.34.3(31.1,35.6)g/L,P=0.006],se-rum calcium[(2.25±0.10)μmol/L vs.(2.13±0.15)μmol/L,P=0.004],but a lower incidence of gestational hypertensive disorders(0 vs.31.6%,P=0.007).In 40 deliveries,there were 27 cases of vaginal delivery(67.5%),13 cases of cesarean section(32.5%).The analysis of neonatal outcomes showed 38 full-term deliveries and 2 preterm deliveries;1 case of macrosomia,1 case of small-for-gesta-tional-age,1 case of low birth weight and 3 cases of birth defects.There were 10 newborns admitted to neonatal intensive care unit,including 4 cases of neonatal infections and 2 cases of neonatal jaundice.Conclusion:Pre-pregnancy counseling and evaluation of IBD patients are very important,and good preg-nancy outcomes can be obtained through careful management during pregnancy in the most of the pa-tients.