Division of Gastroenterology and Hepatology, IBD Clinical Research Program, Mount Sinai Hospital, Sinai Health System, University of Toronto, Suite 441 - 600 University Avenue, Toronto, ON, M5G 1X5, Canada.
Division of Maternal Fetal Medicine, Department of Obstetrics & Gynaecology, Mount Sinai Hospital, Toronto, ON, Canada.
Sci Rep. 2023 May 22;13(1):8291. doi: 10.1038/s41598-023-35332-z.
A home point-of care FCP test (IBDoc) and a self-reported clinical disease activity program (IBD Dashboard) may improve routine monitoring of IBD activity during pregnancy. We aimed to evaluate the feasibility of tight control management using remote monitoring in pregnant patients with IBD. Pregnant patients (< 20 weeks) with IBD were prospectively enrolled from Mount Sinai Hospital between 2019 and 2020. Patients completed the IBDoc and IBD Dashboard at three core time points. Disease activity was measured clinically using the Harvey-Bradshaw Index (mHBI) for CD and partial Mayo (pMayo) for UC, or objectively using FCP. A feasibility questionnaire was completed in the third trimester. Seventy-seven percent of patients (24 of 31) completed the IBDoc and IBD Dashboard at all core time points. Twenty-four patients completed the feasibility questionnaires. All survey respondents strongly preferred using the IBDoc over standard lab-based testing and would use the home kit in the future. Exploratory analysis identified discordance rates of more than 50% between clinical and objective disease activity. Tight control management using remote monitoring may be feasible among pregnant patients with IBD. A combination of both clinical scores and objective disease markers may better predict disease activity.
家庭即时检测（IBDoc）和自我报告的临床疾病活动程序（IBD 仪表盘）可改善妊娠期间对 IBD 活动的常规监测。我们旨在评估远程监测在妊娠 IBD 患者中进行紧密控制管理的可行性。2019 年至 2020 年期间，前瞻性地从西奈山医院招募了妊娠（<20 周）IBD 患者。患者在三个核心时间点完成 IBDoc 和 IBD 仪表盘。使用 CD 的 Harvey-Bradshaw 指数（mHBI）和 UC 的部分 Mayo（pMayo）进行临床疾病活动测量，或使用 FCP 进行客观测量。在妊娠晚期完成可行性问卷。77%的患者（31 名患者中的 24 名）在所有核心时间点完成了 IBDoc 和 IBD 仪表盘。24 名患者完成了可行性问卷。所有调查受访者强烈倾向于使用 IBDoc 替代基于实验室的标准检测，并将在未来使用家用试剂盒。探索性分析发现，临床和客观疾病活动之间的不相符率超过 50%。使用远程监测进行紧密控制管理在妊娠 IBD 患者中可能是可行的。临床评分和客观疾病标志物的组合可能更好地预测疾病活动。
