Clinical Epidemiology Unit and Centre for Pharmacoepidemiology, Department of Medicine, Karolinska University Hospital and Institutet, Stockholm, Sweden.
Clin Gastroenterol Hepatol. 2010 Jun;8(6):509-15. doi: 10.1016/j.cgh.2010.02.014. Epub 2010 Mar 2.
BACKGROUND & AIMS: Women with Crohn's disease (CD) are considered to be at increased risk for adverse outcomes of pregnancy. However, the few studies assessing this risk have had small sample sizes and limitations. We examined outcomes of pregnancy among a large cohort of primiparous women with CD.
Our population-based prevalence study utilized data from medical birth registries in Sweden and Denmark between 1994 and 2006. Linking birth registry data with national patient registries, we identified 2377 women with a hospital diagnosis of CD prior to delivery and 869,202 women with no diagnosis of CD. Using logistic regression analysis, we estimated relative risks with 95% confidence intervals (CI) for pre-eclampsia, preterm birth, 5-minute Apgar scores below 7, cesarean section, small for gestational age (SGA), stillbirth, and congenital malformations.
Maternal CD was associated with increased risk of moderately and very preterm birth (prevalence odds ratio [POR], 1.76; 95% CI, 1.51-2.05; and POR, 1.86; 95% CI, 1.38-2.52, respectively). Maternal CD was also associated with increased risk for cesarean section (POR, 1.93; 95% CI, 1.76-2.12). The strongest associations with CD were observed for prelabor cesarean section and induced preterm delivery. Risk of small size for gestational age birth was slightly increased among women with CD, especially during the time period of 2002-2006 (POR, 1.43; 95% CI, 1.09-1.89). We found no increased risks for pre-eclampsia, low 5-minute Apgar score, stillbirth, or congenital malformations.
Maternal CD is a risk factor for preterm birth, but not birth defects.
患有克罗恩病（CD）的女性被认为妊娠不良结局的风险增加。然而，评估这种风险的少数研究样本量较小且存在局限性。我们检查了大量初次妊娠的 CD 女性的妊娠结局。
我们的基于人群的患病率研究利用了 1994 年至 2006 年瑞典和丹麦的医疗出生登记处的数据。通过将出生登记处的数据与国家患者登记处相联系，我们确定了 2377 名在分娩前被诊断患有 CD 的女性和 869202 名没有 CD 诊断的女性。使用逻辑回归分析，我们估计了子痫前期、早产、5 分钟 Apgar 评分低于 7、剖宫产、小于胎龄儿（SGA）、死产和先天性畸形的相对风险比（95%置信区间）。
母亲 CD 与中度和极早产的风险增加相关（患病率比值比 [POR]，1.76；95%置信区间，1.51-2.05；和 POR，1.86；95%置信区间，1.38-2.52）。母亲 CD 还与剖宫产风险增加相关（POR，1.93；95%置信区间，1.76-2.12）。与 CD 相关性最强的是产前剖宫产和诱导性早产。患有 CD 的女性出生体重稍小的风险增加，尤其是在 2002-2006 年期间（POR，1.43；95%置信区间，1.09-1.89）。我们没有发现子痫前期、低 5 分钟 Apgar 评分、死产或先天性畸形的风险增加。
母亲 CD 是早产的危险因素，但不是出生缺陷的危险因素。
