乳糜泻女性患者的生殖功能和妊娠结局。

Reproductive functions and pregnancy outcome in female patients with celiac disease.

机构信息

Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, India.

Department of Medicine, Lady Harding Medical College, New Delhi, India.

出版信息

J Gastroenterol Hepatol. 2024 Jul;39(7):1310-1317. doi: 10.1111/jgh.16555. Epub 2024 Apr 17.

DOI:10.1111/jgh.16555

PMID:38632832

Abstract

BACKGROUND AND AIM

Abnormalities in the reproductive functions are often ignored while evaluating a patient with celiac disease (CeD). We evaluated the entire reproductive functions in female patients with CeD.

METHODS

In a case control study between 2020 and 2021 using detailed questionnaire, we evaluated reproductive functions (age at menarche, menstrual pattern, fertility, pregnancy outcome and menopause) in biopsy-proven female patients with CeD of age >10 years. The questionnaire was administered either in person or telephonically. Age-matched healthy female controls (twice the number) were also recruited.

RESULTS

Of 1086 CeD patients, 470 were females and 288 were included. As compared with controls (n = 586), females with CeD had higher age at menarche (14.6 ± 2.0 vs 13.6 ± 1.5 years; P = 0.001), delayed menarche (30.8% vs 11.4%; P = 0.001), abnormal menstrual pattern (39.7% vs 25.8%; P < 0.001), involuntary delay in conception at > 1 year (33.8% vs 11.8%; P = 0.01), current infertility rate (10.5% vs 5.2%;P = 0.028), and poorer overall pregnancy outcomes (abortion [23.5% vs 12.8%; P = 0.001], pre-term birth [16.3% vs 3.7%; P = 0.001]).

CONCLUSIONS

Either one or more aspect of reproductive functions and pregnancy outcome is affected adversely in three-fourth female patients with CeD.

摘要

背景与目的

在评估乳糜泻（CeD）患者时，通常会忽略生殖功能的异常。我们评估了患有 CeD 的女性患者的整个生殖功能。

方法

在 2020 年至 2021 年期间，我们进行了一项病例对照研究，使用详细的问卷评估了年龄> 10 岁的经活检证实患有 CeD 的女性患者的生殖功能（初潮年龄、月经模式、生育能力、妊娠结局和绝经）。问卷通过亲自或电话进行管理。还招募了年龄匹配的健康女性对照组（人数是对照组的两倍）。

结果

在 1086 名 CeD 患者中，有 470 名是女性，其中 288 名被纳入研究。与对照组（n=586）相比，患有 CeD 的女性初潮年龄更高（14.6±2.0 岁比 13.6±1.5 岁；P=0.001），初潮延迟（30.8%比 11.4%；P=0.001），月经模式异常（39.7%比 25.8%；P<0.001），受孕时间延迟超过 1 年（33.8%比 11.8%；P=0.01），当前不孕率（10.5%比 5.2%；P=0.028）和较差的整体妊娠结局（流产[23.5%比 12.8%；P=0.001]，早产[16.3%比 3.7%；P=0.001]）。