Baird D D, Narendranathan M, Sandler R S
Epidemilogy Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina.
Gastroenterology. 1990 Oct;99(4):987-94. doi: 10.1016/0016-5085(90)90617-a.
The reproductive histories of 177 women with Crohn's disease and 84 women with ulcerative colitis were compared with those of healthy control subjects. Inflammatory bowel disease was associated with reduced fertility as measured by number of pregnancies, but measures of childlessness, infertility, fecundability, and methods of birth control suggested that this reduced fertility was the patients' choice rather than a consequence of disease-mediated biological impairments. There was no evidence of increased risk of pregnancy loss, but the risk of preterm birth was significantly elevated for patients with Crohn's disease (odds ratio, 3.1; 95% confidence interval, 1.8-5.4) and for those with ulcerative colitis (odds ratio, 2.7; 95% confidence interval, 1.8-5.4). Several plausible biological mechanisms that could explain the link between preterm birth and inflammatory bowel disease are suggested. These results may be useful when counseling patients who desire pregnancy. Physicians can reassure patients about potential fertility problems but should also encourage close obstetrical monitoring during the third trimester of pregnancy.
将177例克罗恩病女性患者和84例溃疡性结肠炎女性患者的生殖史与健康对照者进行了比较。炎症性肠病与妊娠次数所衡量的生育力降低有关，但无子女、不孕、受孕能力及避孕方法等指标表明，生育力降低是患者的选择，而非疾病介导的生物学损伤所致。没有证据表明流产风险增加，但克罗恩病患者（比值比，3.1；95%置信区间，1.8 - 5.4）和溃疡性结肠炎患者（比值比，2.7；95%置信区间，1.8 - 5.4）早产风险显著升高。文中提出了几种可能解释早产与炎症性肠病之间联系的生物学机制。这些结果在为有妊娠意愿的患者提供咨询时可能会有所帮助。医生可以让患者放心潜在的生育问题，但也应鼓励在妊娠晚期进行密切的产科监测。
