Leeds Gastroenterology Institute, Leeds Teaching Hospitals NHS Trust, Leeds, UK
Department of Gastroenterology, University Hospitals Bristol and Weston NHS Trust, Bristol, UK.
BMJ Open Gastroenterol. 2021 Mar;8(1). doi: 10.1136/bmjgast-2021-000603.
The impact of COVID-19 on pregnant inflammatory bowel disease (IBD) patients is currently unknown. Reconfiguration of services during the pandemic may negatively affect medical and obstetric care. We aimed to examine the impacts on IBD antenatal care and pregnancy outcomes.
Retrospective data were recorded in consecutive patients attending for IBD antenatal care including outpatient appointments, infusion unit visits and advice line encounters.
We included 244 pregnant women with IBD, of which 75 (30.7%) were on biologics in whom the treatment was stopped in 29.3% at a median 28 weeks gestation. In addition, 9% of patients were on corticosteroids and 21.5% continued on thiopurines. The care provided during 460 patient encounters was not affected by the pandemic in 94.1% but 68.2% were performed via telephone (compared with 3% prepandemic practice; p<0.0001). One-hundred-ten women delivered 111 alive babies (mean 38.2 weeks gestation, mean birth weight 3324 g) with 12 (11.0%) giving birth before week 37. Birth occurred by vaginal delivery in 72 (56.4%) and by caesarean section in 48 (43.6%) cases. Thirty-three were elective (12 for IBD indications) and 15 emergency caesarean sections. Breast feeding rates were low (38.6%). Among 244 pregnant women with IBD, 1 suspected COVID-19 infection was recorded.
IBD antenatal care adjustments during the COVID-19 pandemic have not negatively affected patient care. Despite high levels of immunosuppression, only a single COVID-19 infection occurred. Adverse pregnancy outcomes were infrequent.
目前尚不清楚 COVID-19 对妊娠炎症性肠病（IBD）患者的影响。大流行期间服务的重新配置可能会对医疗和产科护理产生负面影响。我们旨在研究其对 IBD 产前护理和妊娠结局的影响。
连续记录了 244 名接受 IBD 产前护理的孕妇的回顾性数据，包括门诊预约、输注单位就诊和咨询热线就诊。
我们纳入了 244 名患有 IBD 的孕妇，其中 75 名（30.7%）正在接受生物制剂治疗，其中 29.3%的患者在中位妊娠 28 周时停止治疗。此外，9%的患者接受皮质类固醇治疗，21.5%的患者继续接受硫嘌呤治疗。在大流行期间，94.1%的 460 次患者就诊未受到影响，但 68.2%是通过电话进行的（而大流行前为 3%；p<0.0001）。110 名妇女分娩了 111 名活产婴儿（平均 38.2 周妊娠，平均出生体重 3324 克），其中 12 名（11.0%）在 37 周前分娩。72 例（56.4%）为阴道分娩，48 例（43.6%）为剖宫产。33 例为选择性（12 例为 IBD 指征），15 例为紧急剖宫产。母乳喂养率较低（38.6%）。在 244 名患有 IBD 的孕妇中，记录到 1 例疑似 COVID-19 感染。
COVID-19 大流行期间 IBD 产前护理的调整并未对患者护理产生负面影响。尽管免疫抑制水平较高，但仅发生了 1 例 COVID-19 感染。不良妊娠结局并不常见。
