de Lima A, Zelinkova Z, van der Woude C J
Erasmus University Medical Center Rotterdam, The Netherlands.
Erasmus University Medical Center Rotterdam, The Netherlands IBD Center, Thalion, Bratislava, Slovakia.
J Crohns Colitis. 2015 Jul;9(7):519-24. doi: 10.1093/ecco-jcc/jjv079. Epub 2015 May 4.
Women with inflammatory bowel disease [IBD] have a higher risk of undergoing gastrointestinal [GI] endoscopy during pregnancy than healthy women. Data on endoscopic procedures during pregnancy in IBD women are limited. The aim of this study was to investigate the safety of lower GI endoscopy during pregnancy in IBD women.
All consecutive IBD women who underwent endoscopy during pregnancy [cases] from 2008-2014 were prospectively included. Cases were matched 1:1 on age, IBD medication, and disease activity with pregnant IBD patients without endoscopy during pregnancy [controls]. Maternal and neonatal outcomes were compared between the cases and controls. Adverse events [AEs] were assessed for a temporal relation and for an aetiological relation with the endoscopy.
In total, 42 pregnant IBD patients [19 Crohn's disease, 23 ulcerative colitis] underwent 47 lower GI endoscopies [12 colonoscopies/35 sigmoidoscopies]. Median maternal age was 30 years [interquartile range: 28-32]. Two spontaneous abortions were temporally and probably related to endoscopy; however, spontaneous abortion did not occur more often in cases than in controls (2 [4.8%] vs 10 [23.8%], p 0.01). Median birthweight was significantly lower in the cases compared with controls [3017g vs 3495g, p 0.01]. There were no significant differences in terms of gestational age at birth, congenital abnormalities, or APGAR scores.
Although lower GI endoscopy in pregnant IBD women should only be performed when strongly indicated, we report no increased adverse outcomes for the mother or the newborn related to endoscopy in any of the three trimesters of pregnancy compared with controls.
患有炎症性肠病（IBD）的女性在孕期接受胃肠（GI）内镜检查的风险高于健康女性。关于IBD女性孕期内镜检查的数据有限。本研究的目的是调查IBD女性孕期进行下消化道内镜检查的安全性。
前瞻性纳入2008年至2014年期间所有在孕期接受内镜检查的连续IBD女性（病例组）。病例组与孕期未接受内镜检查的IBD孕妇（对照组）按年龄、IBD用药情况和疾病活动度进行1:1匹配。比较病例组和对照组的母婴结局。评估不良事件（AE）与内镜检查的时间关系和病因关系。
共有42例IBD孕妇（19例克罗恩病，23例溃疡性结肠炎）接受了47次下消化道内镜检查（12次结肠镜检查/35次乙状结肠镜检查）。孕妇的中位年龄为30岁（四分位间距：28 - 32岁）。有2例自然流产在时间上可能与内镜检查有关；然而，病例组自然流产的发生率并不高于对照组（2例[4.8%]对10例[23.8%]，p = 0.01）。病例组新生儿的中位出生体重显著低于对照组（3017g对3495g，p = 0.01）。在出生孕周、先天性异常或阿氏评分方面无显著差异。
尽管IBD孕妇只有在有强烈指征时才应进行下消化道内镜检查，但我们报告与对照组相比，在孕期的任何一个 trimester，母亲或新生儿因内镜检查导致的不良结局均未增加。 （注：原文中trimester未翻译，可能是想保留英文术语，直译为“孕期的任何一个三个月”，此处可根据实际情况灵活处理，比如“孕期的任何一个阶段”等，具体需结合专业知识和上下文确定最合适的表述）
