Bouwknegt Dianne Gelien, van der Weide Albertina Henrika Chantall, Dijkstra Gerard, Goetgebuer Rogier Leon, Oldenburg Lotte, van Dop Willemijn Alexandra, Hirdes Meike Madeleine Catherine, Prins Jelmer Riemer, Hoogenboom Froukje Jantien, van der Woude Christien Janneke, Visschedijk Marijn Caroline
Department of Gastroenterology and Hepatology, University Medical Center Groningen, University of Groningen, 9713GZ, Groningen, The Netherlands.
Department of Gastroenterology and Hepatology, Amsterdam University Medical Center, 1105AZ, Amsterdam, The Netherlands.
Inflamm Bowel Dis. 2025 Aug 1;31(8):2195-2203. doi: 10.1093/ibd/izae301.
Inflammatory bowel disease (IBD) is often diagnosed in young adults, and therefore frequently coincides with pregnancy. Patients may require surgery that includes (temporary) stoma placement. Literature on the occurrence of stoma-complications during pregnancy and the effect on pregnancy outcomes is limited. To evaluate stoma- complications peri- and postpartum, a retrospective study was performed in women who were pregnant while having a stoma.
This multicentre cohort and survey study included all pregnant patients with IBD and a stoma who delivered between 2016 and 2023 from 5 Dutch university hospitals. Stoma-complications and pregnancy outcomes were retrospectively collected from electronic patient files. A questionnaire assessed patient-reported complications and long-term stoma-related complaints.
In total, 50 patients were included (median age at conception 31.0 years; 55.2% Crohn's disease and 44.8% ulcerative colitis), comprising 67 pregnancies, 5 of which ended in pregnancy loss. Stoma complications occurred in 44 full-term pregnancies (71.0%), most commonly obstruction (35.5%) and decreased output (29.0%). Surgery was required in four pregnancies due to obstruction (n = 3) and prolapse (n = 2). In the first-year postpartum, 7 patients required surgery for stoma-complications. Amongst 29 women who completed the questionnaire, 10 (34.5%) reported unresolved complications 6 months postpartum. Cesarean sections were performed in 31 (50.0%) pregnancies. Adverse pregnancy outcomes included prematurity (n = 9, 14.5%), low birth weight (n = 9, 14.5%), and dysmaturity (n = 5, 8.1%).
Pregnancy with a stoma is feasible, though manageable complications often occur. Counseling before pregnancy and close monitoring of symptoms during pregnancy and postpartum are essential for women with IBD and a stoma.
炎症性肠病（IBD）常在年轻成年人中被诊断出来，因此常与妊娠同时发生。患者可能需要进行包括（临时）造口术的手术。关于妊娠期间造口并发症的发生情况及其对妊娠结局的影响的文献有限。为了评估围产期和产后的造口并发症，对有造口的妊娠女性进行了一项回顾性研究。
这项多中心队列和调查研究纳入了2016年至2023年间在5家荷兰大学医院分娩的所有患有IBD且有造口的妊娠患者。从电子病历中回顾性收集造口并发症和妊娠结局。通过问卷调查评估患者报告的并发症和与造口相关的长期主诉。
总共纳入了50例患者（受孕时的中位年龄为31.0岁；55.2%为克罗恩病，44.8%为溃疡性结肠炎），包括67次妊娠，其中5次以流产告终。44例足月妊娠（71.0%）发生了造口并发症，最常见的是梗阻（35.5%）和排出量减少（29.0%）。4例妊娠因梗阻（n = 3）和脱垂（n = 2）需要手术。产后第一年，7例患者因造口并发症需要手术。在完成问卷的29名女性中，10名（34.5%）报告产后6个月仍有未解决的并发症。31例（50.0%）妊娠进行了剖宫产。不良妊娠结局包括早产（n = 9，14.5%）、低出生体重（n = 9，14.5%）和发育不成熟（n = 5，8.1%）。
有造口的妊娠是可行的，尽管常常会出现可处理的并发症。对于患有IBD且有造口的女性，妊娠前咨询以及妊娠和产后对症状的密切监测至关重要。
