Universidad de Chile, Facultad de Medicina Occidente, Hospital San Juan de Dios, Universidad de Chile, Santiago, Chile.
Programa Enfermedad Inflamatoria Intestinal, Departamento Gastroenterología, Clínica Las Condes, Santiago, Chile.
Gastroenterol Hepatol. 2021 Apr;44(4):277-285. doi: 10.1016/j.gastrohep.2020.08.005. Epub 2020 Oct 24.
In inflammatory bowel disease (IBD) a high percentage of women are diagnosed during their reproductive age. IBD in remission is the ideal scenario when planning a pregnancy.
To describe the clinical characteristics of pregnancy/newborn and assess disease activity at the time of conception and throughout the pregnancy in patients with IBD treated at a tertiary centre in Chile.
We retrospectively reviewed women diagnosed with IBD who were pregnant or delivered between 2017 and 2020. Demographic, clinical, obstetric and delivery data were obtained from the IBD registry, approved by the local IRB. Descriptive statistics and association tests were performed (χ2, p ≤ 0.05).
Sixty women with IBD were included. At the beginning of pregnancy, 21 (35%) had active disease and 39 (65%) were in remission. Of those with active disease, 16 (66%) remained active and 6 had spontaneous abortions. In those who were in remission, 26 (69%) remained in this condition. Nine patients (15%) discontinued treatment, and 6 of these had inflammatory activity during pregnancy. Preconception counselling was performed in 23 of the 60 patients, being higher in the group that remained in remission during pregnancy (65% vs. 35%, p = 0.02). Patients who had a flare during pregnancy had more probability of preterm birth (<37 weeks) and newborn with lower weight compared with the group that always remained in remission (89% vs. 74%, p = 0.161) and (2.885 vs 3.370 g; p = 0.0014).
Remission presents better outcomes in pregnancy and preconception counselling would allow a better IBD control during pregnancy.
在炎症性肠病（IBD）中，有很大比例的女性在生育年龄被诊断出患有该疾病。当计划怀孕时，IBD 处于缓解期是理想的情况。
描述在智利一家三级中心接受治疗的 IBD 患者在怀孕/分娩时的临床特征，并评估其在受孕时和整个怀孕期间的疾病活动情况。
我们回顾性地分析了 2017 年至 2020 年期间患有 IBD 且怀孕或分娩的女性患者。从 IBD 登记处获取人口统计学、临床、产科和分娩数据，该登记处获得了当地 IRB 的批准。进行了描述性统计和关联检验（χ2，p ≤ 0.05）。
共纳入 60 名患有 IBD 的女性。在怀孕初期，21 名（35%）患者存在活动期疾病，39 名（65%）患者处于缓解期。在活动期疾病患者中，16 名（66%）患者仍处于活动期，6 名患者发生自然流产。在缓解期患者中，26 名（69%）患者仍处于缓解期。9 名患者（15%）停止治疗，其中 6 名患者在怀孕期间出现炎症活动。60 名患者中有 23 名接受了孕前咨询，在怀孕期间仍处于缓解期的患者中，这一比例更高（65% vs. 35%，p = 0.02）。与始终处于缓解期的患者相比，在怀孕期间出现疾病活动的患者更有可能早产（<37 周）和新生儿体重较低（89% vs. 74%，p = 0.161），且（2.885 与 3.370 g；p = 0.0014）。
缓解期在怀孕期间具有更好的结局，而孕前咨询可以在怀孕期间更好地控制 IBD。
