Friedman Sonia, Zegers Floor Dijkstra, Jølving Line Riis, Nielsen Jan, Nørgård Bente Mertz
Division of Gastroenterology, Hepatology, and Endoscopy, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts and Harvard Medical School, Boston, MA, USA.
Center for Clinical Epidemiology, Odense University Hospital, Odense, Denmark.
Inflamm Bowel Dis. 2023 Feb 1;29(2):260-267. doi: 10.1093/ibd/izac088.
There is lack of knowledge concerning postpartum infections in women with inflammatory bowel disease (IBD). Our aim is to determine the 30-day postpartum infectious complications in women with and without IBD who have a caesarian section, normal vaginal delivery, or assisted vaginal delivery.
We used Danish national registries to establish a study population of liveborn, singleton births from January 1, 1997, through December 31, 2015. We examined 30-day postpartum maternal infectious complications in women with and without IBD, according to the mode of delivery. Statistical models were adjusted for multiple confounders.
In all, 3255 women with and 207 608 without IBD had a caesarian section. Within 30 days postpartum, 4.5% of women with and 3.7% without IBD had an infectious complication. Increased infectious complications included overall infections (adjusted OR [aOR], 1.83; 95% confidence interval [CI], 1.35-2.47), infections of the gastrointestinal tract (aOR, 4.36, 95% CI 2.34-8.10), and infections of the skin and subcutaneous tissue (aOR, 4.45; 95% CI, 2.30-8.50). Other puerperal infections, urological and gynecological, and other infections were increased, although not significantly. For vaginal deliveries, 1.6% of 5771 women with IBD and 1.3% of 793 110 women without IBD had an infectious complication, and the aOR of infections of the gastrointestinal tract was 3.17 (95% CI, 1.47-6.85). There were too few outcomes to calculate the risk of infections after assisted vaginal delivery.
The risk of a 30-day postpartum infectious complication is increased in women with IBD. Physicians should carefully monitor their patients postpartum to prevent these adverse outcomes.
对于患有炎症性肠病（IBD）的女性产后感染情况，人们了解不足。我们的目的是确定接受剖宫产、顺产或阴道助产的患有和未患有IBD的女性产后30天内的感染并发症情况。
我们利用丹麦国家登记处的数据，建立了一个研究队列，纳入1997年1月1日至2015年12月31日期间出生的单胎活产儿。我们根据分娩方式，对患有和未患有IBD的女性产后30天内的母体感染并发症情况进行了研究。统计模型对多个混杂因素进行了校正。
共有3255名患有IBD的女性和207608名未患有IBD的女性接受了剖宫产。产后30天内，患有IBD的女性中有4.5%发生了感染并发症，未患有IBD的女性中有3.7%发生了感染并发症。感染并发症增加的情况包括总体感染（校正比值比[aOR]为1.83；95%置信区间[CI]为1.35 - 2.47）、胃肠道感染（aOR为4.36，95% CI为2.34 - 8.10）以及皮肤和皮下组织感染（aOR为4.45；95% CI为2.30 - 8.50）。其他产褥期感染、泌尿系统和妇科感染以及其他感染也有所增加，尽管未达到显著水平。对于阴道分娩，5771名患有IBD的女性中有1.6%发生了感染并发症，793110名未患有IBD的女性中有1.3%发生了感染并发症，胃肠道感染的aOR为3.17（95% CI为1.47 - 6.85）。由于结局数量太少，无法计算阴道助产术后的感染风险。
患有IBD的女性产后30天发生感染并发症的风险增加。医生应在产后仔细监测患者，以预防这些不良结局。
