Tennenbaum R, Marteau P, Elefant E, Rambaud J C, Modigliani R, Gendre J P, Cosnes J
Services de Gastroentérologie, Hôpital Rothschild, Paris.
Gastroenterol Clin Biol. 1999 May;23(5):464-9.
To assess pregnancy outcome in relation to disease activity and maintenance therapy in patients with inflammatory bowel disease.
A postal questionnaire was sent to every woman of child-bearing age followed for inflammatory bowel disease in three referral centers (Rothschild, Saint-Lazare, Saint-Louis). Response rate was 65%.
One hundred and forty-four pregnancies (153 fetuses) in 138 women (122 had Crohn's disease) were reported. Outcome of pregnancy was normal (baby > 2500 g, without malformation) in 115 cases (77%). There were 17 cases of preterm birth (11.5%), 3 cases of hypotrophy, and 14 pregnancy losses (9 miscarriages (6%), 4 therapeutic abortions for major malformation (2.8%)). Percentages of normal pregnancy outcome were not different between patients who continued maintenance therapy and those who stopped: respective percentages were 75 vs 73% in patients receiving mesalamine or olsalazine (n = 30), and 60 vs 75% in patients receiving azathioprine (n = 22).
In a selected series of women with inflammatory bowel disease, pregnancy outcome is approaching that observed in a normal population, except for an elevated rate of preterm births. There is no need to stop maintenance therapy with 5-aminosalicylates or azathioprine during pregnancy.
评估炎症性肠病患者的妊娠结局与疾病活动及维持治疗的关系。
向三个转诊中心（罗斯柴尔德、圣拉扎尔、圣路易）随访的每一位育龄期炎症性肠病女性患者邮寄问卷。回复率为65%。
共报告了138名女性患者的144次妊娠（153例胎儿）（其中122例患有克罗恩病）。115例（77%）妊娠结局正常（婴儿体重>2500g，无畸形）。有17例早产（11.5%），3例低体重儿，14例妊娠丢失（9例流产（6%），4例因严重畸形行治疗性流产（2.8%））。继续维持治疗的患者与停止维持治疗的患者正常妊娠结局的百分比无差异：接受美沙拉嗪或奥沙拉嗪治疗的患者（n = 30）分别为75%和73%，接受硫唑嘌呤治疗的患者（n = 22）分别为60%和75%。
在一组选定的炎症性肠病女性患者中，除早产率升高外，妊娠结局接近正常人群。孕期无需停用5-氨基水杨酸类药物或硫唑嘌呤的维持治疗。
