Clinical and Population Perinatal Health Research, Kolling Institute, University of Sydney, Sydney, NSW, Australia.
Department of Maternal Fetal Medicine, Royal Hospital for Women, Randwick, NSW, Australia.
BJOG. 2016 Oct;123(11):1862-70. doi: 10.1111/1471-0528.13946. Epub 2016 Feb 29.
To determine the prevalence of the inflammatory bowel diseases (IBD), ulcerative colitis (UC) and Crohn's disease (CD), in pregnant women and determine pregnancy and fetal/neonatal outcomes.
Population-based cohort study.
New South Wales, Australia, 2001-11.
A total of 630 742 women who delivered at ≥20 weeks of gestation.
Descriptive and multivariate regression analyses of perinatal data linked to hospital admission data. We compared birth outcomes of women with and without a documented diagnosis of IBD.
Caesarean section, severe maternal morbidity, preterm birth <37 weeks of gestation, planned preterm birth, small-for-gestational-age (birthweight <10th centile), perinatal mortality (stillbirth/neonatal death ≤28 days).
In all, 1960 women (0.31%) with IBD, who had 2781 births (1183 UC, 1287 CD and 311 IBD-indeterminate). Women with IBD were more likely than women without IBD to have a caesarean section [41.5 versus 28.2%, adjusted risk ratio (aRR) 1.38, 95% CI 1.31-1.45], severe maternal morbidity (2.6 versus 1.6%, aRR 1.54, 95% CI 1.17-2.03), preterm birth (9.7 versus 6.6%, aRR 1.47, 95% CI 1.30-1.66), planned preterm birth (5.3 versus 2.9%, aRR 1.74, 95% CI 1.47-2.07), and their infants to be small-for-gestational-age (9.7 versus 9.5%, aRR 1.19, 95% CI 1.04-1.36). There was no evidence of a difference in perinatal mortality.
Pregnancy-associated IBD is more common than previously reported. Pregnancies complicated by IBD at or near the time of birth have significantly higher rates of adverse pregnancy outcomes than pregnancies of women without IBD.
Increased rates preterm birth and caesarean section in women with inflammatory bowel disease.
确定炎症性肠病（IBD）、溃疡性结肠炎（UC）和克罗恩病（CD）在孕妇中的流行率，并确定妊娠和胎儿/新生儿结局。
基于人群的队列研究。
澳大利亚新南威尔士州，2001-11 年。
共有 630742 名在妊娠 20 周以上分娩的妇女。
对与住院数据相关的围产期数据进行描述性和多变量回归分析。我们比较了有和没有记录的 IBD 诊断的妇女的分娩结果。
剖宫产、严重产妇发病率、早产 <37 周、计划早产、小于胎龄儿（出生体重 <第 10 百分位数）、围产儿死亡率（死产/新生儿死亡≤28 天）。
共有 1960 名（0.31%）患有 IBD 的妇女分娩了 2781 名婴儿（1183 名 UC、1287 名 CD 和 311 名 IBD 不确定）。与没有 IBD 的妇女相比，患有 IBD 的妇女更有可能行剖宫产[41.5%比 28.2%，调整后的风险比（aRR）1.38，95%可信区间（95%CI）1.31-1.45]、发生严重产妇发病率（2.6%比 1.6%，aRR 1.54，95%CI 1.17-2.03）、早产（9.7%比 6.6%，aRR 1.47，95%CI 1.30-1.66）、计划早产（5.3%比 2.9%，aRR 1.74，95%CI 1.47-2.07），其婴儿为小于胎龄儿（9.7%比 9.5%，aRR 1.19，95%CI 1.04-1.36）。围产儿死亡率无差异。
与先前报道相比，妊娠相关的 IBD 更为常见。在接近分娩时患有 IBD 的妊娠其不良妊娠结局的发生率明显高于没有 IBD 的妊娠。
患有炎症性肠病的女性早产和剖宫产的比例增加。
