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从患者角度看炎症性肠病女性妊娠相关问题的探讨

Addressing pregnancy-related concerns in women with inflammatory bowel disease: Insights from the patient's perspective.

作者信息

Flanagan Emma K, Richmond Jacqui, Thompson Alexander J, Desmond Paul V, Bell Sally J

机构信息

Department of Gastroenterology St Vincent's Hospital Melbourne Victoria Australia.

Disease Elimination The Burnet Institute Melbourne Victoria Australia.

出版信息

JGH Open. 2020 Nov 9;5(1):28-33. doi: 10.1002/jgh3.12442. eCollection 2021 Jan.

Abstract

BACKGROUND AND AIM

Therapeutic options for inflammatory bowel disease (IBD) have expanded, as has the use of IBD medications in women during the reproductive period. However, no qualitative data exist that examine the pregnancy-related concerns of women with IBD in the current era of widespread immunomodulator and biologic use. Hence, we aimed to explore in detail the impact of IBD on pregnancy from the patient's perspective.

METHODS

This qualitative study used semistructured interviews to explore participants' experiences regarding IBD and pregnancy until no new themes emerged. Key themes were identified using thematic analysis.

RESULTS

Fifteen women with IBD were interviewed. The majority of participants reported lingering concerns regarding their IBD medications, despite advice from their gastroenterologist that the drugs were considered safe in pregnancy. Participants more often reported medication-related fears, such as potential negative effects on their child's immune system, than concerns regarding the effect of the disease itself on their pregnancy outcomes. A common theme was a perceived lack of knowledge among non-IBD clinicians regarding IBD medications during pregnancy, which augmented pre-existing anxiety.

CONCLUSIONS

This study is the first of its kind to provide an in-depth assessment of female patients' perspectives of IBD in relation to conception, pregnancy, and caring for offspring. In particular, this research characterizes the unique fears and persisting anxieties regarding IBD medications in pregnancy. The study has unearthed important insights into the specific concerns and support needs of women with IBD in order to facilitate nonjudgmental counseling designed around patient concerns and beliefs.

摘要

背景与目的

炎症性肠病(IBD)的治疗选择有所增加,在育龄期女性中IBD药物的使用情况亦是如此。然而,在免疫调节剂和生物制剂广泛应用的当前时代,尚无定性数据来研究IBD女性患者与妊娠相关的担忧。因此,我们旨在从患者角度详细探讨IBD对妊娠的影响。

方法

这项定性研究采用半结构式访谈来探究参与者关于IBD和妊娠的经历,直至没有新的主题出现。使用主题分析法确定关键主题。

结果

对15名IBD女性进行了访谈。尽管胃肠病学家告知她们这些药物在孕期被认为是安全的,但大多数参与者仍对其IBD药物存在持续的担忧。与对疾病本身对妊娠结局的影响的担忧相比,参与者更常报告与药物相关的恐惧,比如对孩子免疫系统的潜在负面影响。一个共同的主题是,非IBD临床医生在孕期对IBD药物的认知不足,这加剧了她们原有的焦虑。

结论

本研究首次对女性患者关于IBD在受孕、妊娠及照料后代方面的观点进行了深入评估。特别是,这项研究明确了对孕期IBD药物的独特恐惧和持续焦虑。该研究揭示了IBD女性患者的具体担忧和支持需求的重要见解,以便围绕患者的担忧和信念开展无偏见的咨询服务。

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