妊娠期溃疡性结肠炎:一项日本多中心队列研究,聚焦它们之间的相互影响。

IF 1 4区 医学 Q3 MEDICINE, GENERAL & INTERNAL
Yuichi Shimodate, Akiko Shiotani, Ken-Ichi Tarumi, Hiroshi Matsumoto, Osamu Handa, Noriaki Tomioka, Naoyuki Nishimura, Kazuhiro Matsueda, Hirokazu Mouri, Motowo Mizuno
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引用次数: 0

摘要

目的 研究妊娠期溃疡性结肠炎(UC)的临床病程,重点关注两者之间的相互影响。方法 我们回顾性地查阅了 58 名溃疡性结肠炎患者 73 次妊娠的病历,以及 3 名在妊娠期间新发溃疡性结肠炎的患者的病历。我们记录了 UC 的复发率;妊娠期用药与 UC 复发的关系;复发治疗;以及妊娠、分娩和新生儿畸形的发生率。结果 78%的患者在受孕时尿毒症病情得到缓解。怀孕期间的复发率为 27.3%,大多数复发发生在第二和第三个孕期。停用任何一种 UC 药物的患者的复发率为 50%,明显高于继续服用所有药物的 20.5% 患者(P = 0.016)。60%(6/10)的患者在受孕时停用了硫嘌呤,50%(3/6)的患者病情复发。大多数复发患者都成功接受了 5-氨基水杨酸或皮质类固醇激素治疗。26.1%的患者(18/70)在分娩后出现 UC 复发,多数在 2 个月内复发。23.3%的患者(17/73)出现妊娠、分娩或新生儿异常。在 3 例新发 UC 患者中,有 2 例 UC 严重,需要重症监护;然而,他们的妊娠过程并无异常。结论 虽然合并有 UC 的妊娠大多进展顺利,但停止用药会有 UC 复发的风险。因此,在妊娠期间适当管理 UC 的药物治疗非常重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Ulcerative Colitis in Pregnancy: A Japanese Multicenter Cohort Study Focusing on Their Mutual Influence.

Objective To investigate the clinical course of ulcerative colitis (UC) during pregnancy, focusing on their mutual influence. Methods We retrospectively reviewed the medical records of 58 patients with UC who had 73 pregnancies and 3 patients with newly developed UC during pregnancy. We recorded the rate of relapse of UC; the relationship between medication use and UC relapse during pregnancy; treatment for relapse; and the incidence of pregnancy, childbirth, and newborn abnormalities. Results UC was in remission at conception in 78% of the patients. The relapse rate during pregnancy was 27.3%, with most relapses occurring during the second and third trimesters. The relapse rate in patients in whom any UC drug had been discontinued was 50%, a rate significantly higher than the 20.5% of patients for whom all medications were continued (p = 0.016). Thiopurine was discontinued in 60% (6/10) of patients at conception, and the disease relapsed in 50% (3/6) of the patients. Most relapses were successfully treated with 5-aminosalicylic acid or corticosteroids. UC relapse occurred in 26.1% (18/70) of the patients after delivery, mostly within 2 months. Pregnancy, delivery, or neonatal abnormalities occurred in 23.3% (17/73) of patients. In two of the three patients with new-onset UC, UC was severe and required intensive care; however, the pregnancies continued uneventfully. Conclusion Although the progress of pregnancies complicated by UC was mostly uneventful, discontinuing medication carries the risk of UC relapse. Thus, appropriate management of medical treatments for UC during pregnancy is important.

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来源期刊
Internal Medicine
Internal Medicine 医学-医学:内科
CiteScore
1.90
自引率
8.30%
发文量
0
审稿时长
2.2 months
期刊介绍: Internal Medicine is an open-access online only journal published monthly by the Japanese Society of Internal Medicine. Articles must be prepared in accordance with "The Uniform Requirements for Manuscripts Submitted to Biomedical Journals (see Annals of Internal Medicine 108: 258-265, 1988), must be contributed solely to the Internal Medicine, and become the property of the Japanese Society of Internal Medicine. Statements contained therein are the responsibility of the author(s). The Society reserves copyright and renewal on all published material and such material may not be reproduced in any form without the written permission of the Society.
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