Noel Nicolas, Wechsler Bertrand, Nizard Jacky, Costedoat-Chalumeau Nathalie, Boutin Du Le Thi Huong, Dommergues Marc, Vauthier-Brouzes Danièle, Cacoub Patrice, Saadoun David
Groupe Hospitalier Pitié-Salpêtrière, AP-HP, and Université Pierre et Marie Curie, Paris VI, Paris, France.
Arthritis Rheum. 2013 Sep;65(9):2450-6. doi: 10.1002/art.38052.
To describe the interplay between Behçet's disease (BD) and pregnancy.
This retrospective study included 76 pregnancies in 46 patients fulfilling the international criteria for BD. The median age of the patients at the time of entry into the study was 28.4 years (interquartile range 22.8-30.9 years). Patients were used as their own historical controls to assess the incidence of BD flares during pregnancy and before or after pregnancy. Factors associated with the occurrence of complications during pregnancy were assessed.
Among the 76 pregnancies with BD analyzed, 27 (35.5%) were associated with worsening of the symptoms of BD flare; oral and genital ulcerations (78.4% and 67.6%, respectively) as well as ocular complications (32.4%) were the most frequent. The mean ± SD annual rates of BD flares were 0.49 ± 0.72 during pregnancy and 1.46 ± 2.42 during the nonobstetric period (P = 0.018). The proportion of BD flares tended to be lower in patients treated with colchicine (27.9% versus 45.4% of patients not treated with colchicine; P = 0.11). The overall rate of complications during pregnancy was 15.8%. The complications included miscarriage (5 patients), cesarean delivery (3 patients), medical termination of pregnancy (2 patients), hemolysis, elevated liver enzymes, and low platelets syndrome (1 patient), and immune thrombocytopenia (1 patient). There was a statistically significant association between a history of deep vein thrombosis in BD and the risk of obstetric complications (odds ratio 7.25, 95% confidence interval 1.21-43.46, P = 0.029). Neither gestational age at delivery nor neonatal outcome was influenced by BD.
The disease course in BD seems to improve during pregnancy, mostly in patients who are treated with colchicine. Pregnancy in patients with BD appears not to be associated with an increased rate of pregnancy-related complications.
描述白塞病（BD）与妊娠之间的相互作用。
这项回顾性研究纳入了46例符合BD国际诊断标准的患者的76次妊娠。研究纳入时患者的中位年龄为28.4岁（四分位间距22.8 - 30.9岁）。以患者自身作为历史对照，评估妊娠期间以及妊娠前后BD病情加重的发生率。评估与妊娠期间并发症发生相关的因素。
在分析的76例患有BD的妊娠中，27例（35.5%）与BD病情加重有关；口腔和生殖器溃疡（分别为78.4%和67.6%）以及眼部并发症（32.4%）最为常见。BD病情加重的年平均发生率±标准差在妊娠期间为0.49±0.72，在非产科期间为1.46±2.42（P = 0.018）。接受秋水仙碱治疗的患者中BD病情加重的比例趋于较低（27.9%，未接受秋水仙碱治疗的患者为45.4%；P = 0.11）。妊娠期间并发症的总体发生率为15.8%。并发症包括流产（5例患者）、剖宫产（3例患者）、药物流产（2例患者）、溶血、肝酶升高和血小板减少综合征（1例患者）以及免疫性血小板减少症（1例患者）。BD患者深静脉血栓形成病史与产科并发症风险之间存在统计学显著关联（比值比7.25，95%置信区间1.21 - 43.46，P = 0.029）。分娩时的孕周和新生儿结局均不受BD影响。
BD的病程在妊娠期间似乎有所改善，主要是在接受秋水仙碱治疗的患者中。BD患者的妊娠似乎与妊娠相关并发症发生率增加无关。
