Department of Medicine, University of Toronto, Toronto, Canada.
Division of Gastroenterology, Mount Sinai Hospital, 441 - 600 University Avenue, Toronto, ON, M5G 1X5, Canada.
Dig Dis Sci. 2022 Nov;67(11):5177-5186. doi: 10.1007/s10620-022-07430-x. Epub 2022 Feb 24.
Ulcerative colitis (UC) and Crohn's disease (CD) are chronic inflammatory bowel diseases (IBD) that affect women in their childbearing years. Early pregnancy flare-up negatively impacts obstetrical and perinatal outcomes, but the impact on infants is unclear.
To determine whether active IBD disease activity is associated with adverse post-neonatal outcomes post-partum.
This is a single-center cohort study of women with IBD who underwent serial monitoring of post-neonatal outcomes post-partum. Infant outcomes were collected via self-filled questionnaires, including perinatal outcomes, APGAR scores, infant weights, heights, feeding habits and comorbidities within the first year of life.
There was a total of 98 women with IBD and 78 live births throughout the study: 50 women were enrolled during trimester one alone and 49 were included into the current study. Among the 49 analyzed, 32 were in remission and 17 were in relapse during trimester one. Trimester one disease activity was associated with more adverse obstetrical outcomes including emergency C-sections and reduced 1-min APGAR scores. At follow-up, infants born to women with T1-flare had reduced weight-for-age Z scores and length-for-age Z scores up to 6 months of age.
Active IBD during trimester one is correlated with adverse post-neonatal outcomes, particularly decreased infant weight and height up to 6 months of age. This suggests disease control in first trimester is essential for optimizing infant growth and post-neonatal outcomes.
溃疡性结肠炎(UC)和克罗恩病(CD)是影响育龄妇女的慢性炎症性肠病(IBD)。妊娠早期疾病发作会对母婴结局产生负面影响,但对婴儿的影响尚不清楚。
确定 IBD 活动期疾病是否与产后新生儿期后不良结局相关。
这是一项单中心队列研究,纳入了接受产后新生儿期结局连续监测的 IBD 女性。通过自我填写的问卷收集婴儿结局,包括围产期结局、阿普加评分、婴儿体重、身高、喂养习惯以及出生后 1 年内的合并症。
共有 98 名 IBD 女性和 78 例活产纳入研究:50 名女性仅在孕早期入组,49 名纳入本研究。在 49 名分析对象中,32 名处于缓解期,17 名处于孕早期疾病活动期。孕早期疾病活动与更多不良产科结局相关,包括急诊剖宫产和降低 1 分钟阿普加评分。随访时,在 T1 期发作的女性所生婴儿的体重-年龄 Z 评分和身高-年龄 Z 评分在 6 个月龄前均较低。
孕早期 IBD 活动与产后新生儿期不良结局相关,尤其是婴儿体重和身高在 6 个月龄前降低。这表明孕早期疾病控制对于优化婴儿生长和新生儿期后结局至关重要。