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皮肤科医生的立场和患者对银屑病和妊娠的关注的交叉观察:PREGNAN-PSO 研究的初步结果。

Crossed looks on the dermatologist's position and the patient's preoccupations as to psoriasis and pregnancy: preliminary results of the PREGNAN-PSO study.

机构信息

Groupe d'Études Multicentriques ResoPso, La Varenne Saint-Hilaire, France.

Groupe d'Études Multicentriques ResoPso, Bégin Military Teaching Hospital, Saint-Mandé, France.

出版信息

J Eur Acad Dermatol Venereol. 2019 May;33(5):880-885. doi: 10.1111/jdv.15423. Epub 2019 Feb 27.

Abstract

BACKGROUND

While some information on psoriasis impact on pregnancy is available, very little is known on the preoccupations of women afflicted by the disease or on the dermatologists' (D) positioning as to psoriasis and pregnancy. The 'Objectifs Peau' project demonstrated a 4.7% prevalence of psoriasis in women aged 18-45 years in France.

OBJECTIVE

This project sought to further address these issues in view of a targeted action plan.

METHODS

A questionnaire was made available to 361 D of different types.

RESULTS

Overall, 152 D answered the questionnaire, 50.7% working in private or mixed practice and 49.3% in hospitals, with 63% females (DF) and 37% males (DM). Over the last 3 months, the mean percentage of women of child-bearing age seen by these D was 28.6%. The main issue addressed by D upon psoriasis diagnosis was the patient's wish to become pregnant in the short-term (84%), while the compatibility of drug treatment with pregnancy was the issue prioritized by patients (64%). Among DM and DF, 46% and 29% reported having been confronted with an unplanned pregnancy, with their reaction mainly dependent on the treatment taken in 66%. Regarding follow-up, 26% D declared having shared their decision-making with gynaecologists, while 56% considered the first pregnancy trimester to be the highest-risk period. Only 28% D were familiar with existing recommendations, with only 21% of them considering them appropriate.

CONCLUSION

Overall, 26.2% of French psoriasis women are of child-bearing potential, in line with our dataset (28.6%). Only 56% D considered the 1st pregnancy trimester to be the highest-risk period, with only one-third familiar with existing recommendations. The gap between recommendations and actual practices must be addressed through policies that take women's preoccupations better into account.

摘要

背景

尽管有一些关于银屑病对妊娠影响的信息,但对于患有该疾病的女性的关注点以及皮肤科医生(D)对银屑病和妊娠的立场,我们知之甚少。“Objectifs Peau”项目表明,法国 18-45 岁女性银屑病的患病率为 4.7%。

目的

鉴于制定有针对性的行动计划,本项目旨在进一步解决这些问题。

方法

向 361 名不同类型的 D 发放了问卷。

结果

总体而言,有 152 名 D 回答了问卷,其中 50.7%在私人或混合诊所工作,49.3%在医院工作,女性占 63%(DF),男性占 37%(DM)。在过去的 3 个月中,这些 D 看诊的育龄期女性的平均比例为 28.6%。D 在诊断银屑病时主要关注的问题是患者短期内怀孕的愿望(84%),而患者优先考虑的是药物治疗与妊娠的兼容性(64%)。在 DM 和 DF 中,46%和 29%报告曾遇到过意外怀孕,他们的反应主要取决于 66%所采取的治疗。关于随访,26%的 D 表示曾与妇科医生分享过他们的决策,而 56%的 D 认为妊娠的第一个三个月是风险最高的时期。只有 28%的 D 熟悉现有的建议,只有 21%的 D 认为这些建议是合适的。

结论

总体而言,26.2%的法国银屑病女性具有生育潜力,与我们的数据一致(28.6%)。只有 56%的 D 认为妊娠的第一个三个月是风险最高的时期,只有三分之一的 D 熟悉现有的建议。建议与实际做法之间的差距必须通过更好地考虑女性关注点的政策来解决。

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