Agret F, Cosnes J, Hassani Z, Gornet J-M, Gendre J-P, Lémann M, Beaugerie L
Department of Gastroenterology, Saint-Louis Hospital, and Paris 7 University, Paris, France.
Aliment Pharmacol Ther. 2005 Mar 1;21(5):509-13. doi: 10.1111/j.1365-2036.2005.02384.x.
The impact of pregnancy on Crohn's disease activity has been poorly investigated.
To determine the effect of pregnancy on Crohn's disease activity from the retrospective analysis of a cohort of women who had a regular clinical follow-up.
Seventy pregnancies occurring in 61 women were studied. The Harvey-Bradshaw index was determined during the four quarters preceding each pregnancy, the three quarters of pregnancy and the four quarters following delivery.
The mean Harvey-Bradshaw index during pregnancy [0.68 (0.18), mean (S.E.M.)] was significantly lower than that of the year preceding pregnancy [0.98 (0.16), P = 0.03] and that of the year following delivery [1.10 (0.17), P = 0.04]. In non-smoking women (48 pregnancies), there was no significant change of Harvey-Bradshaw index between these intervals. Whereas in those who smoked (22 pregnancies), most of whom reduced tobacco consumption during pregnancy, the mean Harvey-Bradshaw index during pregnancy was significantly reduced compared with that of the year following delivery [0.58 (0.20) vs. 1.60 (0.33), P = 0.01]. The use of drugs was significantly lower during pregnancy.
Crohn's disease activity is mildly but significantly lower during pregnancy. The reduction of tobacco consumption during pregnancy in smoking women may play an important role in this improvement.
妊娠对克罗恩病活动的影响尚未得到充分研究。
通过对一组接受定期临床随访的女性队列进行回顾性分析，确定妊娠对克罗恩病活动的影响。
对61名女性发生的70次妊娠进行研究。在每次妊娠前四个季度、妊娠期间三个季度以及分娩后四个季度测定哈维 - 布拉德肖指数。
妊娠期间哈维 - 布拉德肖指数的平均值[0.68（0.18），均值（标准误）]显著低于妊娠前一年的平均值[0.98（0.16），P = 0.03]以及分娩后一年的平均值[1.10（0.17），P = 0.04]。在不吸烟女性（48次妊娠）中，这些时间段内哈维 - 布拉德肖指数无显著变化。而在吸烟女性（22次妊娠）中，她们大多数在妊娠期间减少了烟草消费，妊娠期间哈维 - 布拉德肖指数的平均值与分娩后一年相比显著降低[0.58（0.20）对1.60（0.33），P = 0.01]。妊娠期间药物使用显著减少。
妊娠期间克罗恩病活动轻度但显著降低。吸烟女性在妊娠期间减少烟草消费可能在这种改善中起重要作用。
