Morales M, Berney T, Jenny A, Morel P, Extermann P
Department of Obstetrics and Gynecology, Geneva University Hospital, Geneva, Switzerland.
Hepatogastroenterology. 2000 Nov-Dec;47(36):1595-8.
BACKGROUND/AIMS: To study the effects of Crohn's disease on the course of pregnancy and the influence of pregnancy on the activity of Crohn's disease.
The course of 35 pregnancies in 23 women with Crohn's disease were reviewed over a 12 years period.
Nine pregnancies (25%) started when Crohn's disease was active. We observed 2 exacerbations among the 9 pregnancies with active disease and 7 exacerbations among the 26 pregnancies with quiescent disease: this represents a total exacerbation rate of 26% similar to non-pregnant women with Crohn's disease. The course of pregnancy was normal with a full-term delivery in 22 cases (63%). We observed 5 premature deliveries (14%), 5 spontaneous abortions (14%), 1 induced abortion (3%) and 2 liveborns with severe malformations (6%). Preterm delivery was significantly associated with reactivation of Crohn's disease during pregnancy (P = 0.009), whereas fetal loss was significantly associated with activity of Crohn's disease at the time of conception (P = 0.015).
Pregnancy does not appear to influence the course of Crohn's disease. The relapse rate of Crohn's disease during pregnancy is similar to that of the general Crohn's disease population. Active Crohn's disease at the time of conception or reactivation during pregnancy are risk factors for abnormal pregnancy outcome.
背景/目的：研究克罗恩病对妊娠过程的影响以及妊娠对克罗恩病活动的影响。
回顾了23例患有克罗恩病的女性在12年期间的35次妊娠过程。
9次妊娠（25%）在克罗恩病活动期开始。我们观察到，在9例疾病活动期的妊娠中有2例病情加重，在26例疾病静止期的妊娠中有7例病情加重：这代表总加重率为26%，与非妊娠的克罗恩病女性相似。妊娠过程正常，22例（63%）足月分娩。我们观察到5例早产（14%）、5例自然流产（14%）、1例人工流产（3%）和2例出生时有严重畸形的活产儿（6%）。早产与妊娠期间克罗恩病的复发显著相关（P = 0.009），而胎儿丢失与受孕时克罗恩病的活动显著相关（P = 0.015）。
妊娠似乎不影响克罗恩病的病程。妊娠期间克罗恩病的复发率与一般克罗恩病患者群体相似。受孕时克罗恩病活动或妊娠期间复发是异常妊娠结局的危险因素。
