Department of Gastroenterology and Hepatology, Mayo Clinic, 200 1ST St SW, Rochester, MN, 55905, USA.
Department of Gastroenterology and Hepatology, Tufts Medical Center, Boston, MA, USA.
Dig Dis Sci. 2022 Sep;67(9):4295-4302. doi: 10.1007/s10620-021-07210-z. Epub 2021 Aug 18.
Previous studies have been inconsistent in reporting the risk of pregnancy-related complications in women with IBD. We aimed to investigate the differences in frequencies of pregnancy-related complications requiring hospitalization in women with IBD compared to women without IBD.
We performed a population-based, cross-sectional study using the 2014 USA National Inpatient Sample. Frequencies of ICD-9 codes for pregnancy-related complications in women aged 18-35 years with IBD were compared to women with no IBD controlling for confounders predisposing to pregnancy complications. Adjusted odds ratios were calculated for each outcome.
A total of 6705 women with IBD and a pregnancy complication were discharged from the hospital in 2014. In multivariate analyses, there was no statistically significant difference between women with and without IBD for: spontaneous abortion, post-abortion complications, ectopic pregnancy, hemorrhage, severe preeclampsia, eclampsia, early labor, polyhydramnios, hyperemesis, missed abortion, mental disorder during pregnancy, and forceps delivery. Women with IBD had significant lower odds for prolonged pregnancy, gestational diabetes, fetal distress, umbilical cord complications, obstetric trauma, mild preeclampsia, and hypertension. There was, however, higher odds for infectious and parasitic complications (OR 1.74, 95% CI 1.42-2.14, p < 0.0001), UTIs (OR 1.65, 95% CI 1.07-2.60, p = 0.02), and anemia (OR 5.26, 95% CI 4.01-6.90, p < 0.0001).
In this large population-based analysis, women with IBD had higher odds for certain infections such as UTIs and anemia during pregnancy when compared to women with no IBD. For other pregnancy-related complications, women with IBD had the same or lower odds than women with no IBD. These data are important to share with women with IBD considering pregnancy.
既往研究报告的炎症性肠病（IBD）女性患者妊娠相关并发症风险并不一致。本研究旨在调查 IBD 女性患者与无 IBD 女性患者相比，因妊娠相关并发症而住院的频率差异。
我们利用 2014 年美国全国住院患者样本进行了一项基于人群的横断面研究。比较了年龄在 18-35 岁的 IBD 女性患者和无 IBD 女性患者的妊娠相关并发症 ICD-9 编码的频率，同时控制了易发生妊娠并发症的混杂因素。对每种结局计算了校正比值比（OR）。
2014 年共有 6705 名患有 IBD 并发生妊娠并发症的女性出院。多变量分析显示，IBD 女性与无 IBD 女性之间：自然流产、流产后并发症、异位妊娠、出血、重度子痫前期、子痫、早产、羊水过多、妊娠剧吐、稽留流产、妊娠期间精神障碍、产钳分娩的差异无统计学意义。IBD 女性患者妊娠延长、妊娠期糖尿病、胎儿窘迫、脐带并发症、产科创伤、轻度子痫前期和高血压的几率显著降低。但感染和寄生虫并发症（OR 1.74，95%CI 1.42-2.14，p<0.0001）、尿路感染（OR 1.65，95%CI 1.07-2.60，p=0.02）和贫血（OR 5.26，95%CI 4.01-6.90，p<0.0001）的几率更高。
在这项大型基于人群的分析中，与无 IBD 的女性相比，IBD 女性在妊娠期间发生某些感染（如尿路感染和贫血）的几率更高。对于其他妊娠相关并发症，IBD 女性与无 IBD 的女性相比，其几率相同或更低。这些数据对于考虑妊娠的 IBD 女性非常重要。
