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炎症性肠病中的计划生育:女性患者的无子女状况及与疾病相关的担忧

Family planning in inflammatory bowel disease: childlessness and disease-related concerns among female patients.

作者信息

Walldorf Jens, Brunne Susanne, Gittinger Fleur S, Michl Patrick

机构信息

Department of Internal Medicine I, Martin-Luther-University of Halle-Wittenberg, Halle, Germany.

出版信息

Eur J Gastroenterol Hepatol. 2018 Mar;30(3):310-315. doi: 10.1097/MEG.0000000000001037.

Abstract

OBJECTIVE

Inflammatory bowel disease (IBD) frequently affects women when family planning and pregnancy (FPP) are important issues. This survey aimed to identify patients with an increased need for medical counselling.

PATIENTS AND METHODS

An internet-based questionnaire was offered to women with IBD. Characteristics in terms of FPP were analysed with respect to sociodemographic and disease-related factors.

RESULTS

Childlessness was frequently reported (64.8% of 443 participants). In women older than 35 years with IBD, childlessness was significantly more prevalent than that in the general population (36.7 vs. 22.9%, odds ratio=1.9, P<0.001). Overall, 44.2% of the women were satisfied with counselling in general, and only 27.3% with the specific advice on FPP. Women younger than 25 years were rarely satisfied with the advice in terms of FPP (18.2%) and demanded an intensified counselling (44.6%). Frequent concerns were the heritability of IBD (all women, 59.2%; mothers, 51.5%; childless, 62.5%, P<0.01), medication during FPP (44.7, 26.1, 52.4%, P<0.01) and miscarriage (38.9, 16.8, 48.7%, P<0.01).

CONCLUSION

The prevalence of childlessness in women with IBD compared with the general population increases with age. FPP-related worries, especially in terms of heredity, medication and miscarriage, are associated with an increased risk for childlessness. The results underline the importance of qualified counselling as early as possible during the course of the disase.

摘要

目的

炎症性肠病(IBD)常影响处于计划生育和妊娠(FPP)这两个重要阶段的女性。本调查旨在确定对医学咨询需求增加的患者。

患者与方法

向患有IBD的女性提供了一份基于互联网的问卷。针对社会人口统计学和疾病相关因素,分析了FPP方面的特征。

结果

经常有患者报告无子女(443名参与者中的64.8%)。在年龄大于35岁的IBD女性中,无子女的情况比普通人群更为普遍(36.7%对22.9%,优势比=1.9,P<0.001)。总体而言,44.2%的女性对一般咨询感到满意,而对FPP的具体建议感到满意的仅占27.3%。年龄小于25岁的女性很少对FPP方面的建议感到满意(18.2%),并要求加强咨询(44.6%)。常见的担忧包括IBD的遗传性(所有女性为59.2%;母亲为51.5%;无子女者为62.5%,P<0.01)、FPP期间的用药(44.7%、26.1%、52.4%,P<0.01)以及流产(38.9%、16.8%、48.7%,P<0.01)。

结论

与普通人群相比,IBD女性中无子女的患病率随年龄增长而增加。与FPP相关的担忧,尤其是在遗传、用药和流产方面,与无子女风险增加有关。结果强调了在疾病过程中尽早进行专业咨询的重要性。

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