孕前、妊娠和产后炎症性肠病妇女和非炎症性肠病妇女保健利用的差异:一项基于人群的队列研究

IF 8.3 2区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY
Parul Tandon, Vivian W Huang, Denice S Feig, Refik Saskin, Cynthia Maxwell, Yiding Gao, Deshayne B Fell, Cynthia H Seow, John W Snelgrove, Geoffrey C Nguyen
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引用次数: 0

摘要

背景和目的:与没有炎症性肠病(IBD)的妇女相比,患有IBD的妇女在怀孕和产后可能有更多的医疗保健利用,尽管这还有待证实。我们的目标是描述这些群体之间的医疗保健使用情况。方法:访问管理数据库,确定2003年至2018年期间有IBD或无IBD的单胎妊娠妇女[18-55岁]。分析了孕前、妊娠和产后12个月急诊科就诊、住院和产前护理的差异。采用多变量负二项回归以95%置信区间报告发病率比[IRRs]。协变量包括母亲的受孕年龄、居住地、社会经济地位和母亲的合并症。结果:共纳入6163例IBD女性[9158例妊娠]和1091 013例非IBD女性[1729 411例妊娠]。患有IBD的妇女在怀孕期间更有可能去急诊科[IRR 1.13, 95% CI 1.08-1.18]并住院[IRR 1.11, 95% CI 1.01-1.21],产后更有可能去急诊科[IRR 1.21, 95% CI 1.15-1.27]并住院[IRR 1.18, 95% CI 1.05-1.32]。未经调整的分析显示,患有IBD的女性更有可能因静脉血栓栓塞事件住院。在孕前保健使用方面没有差异。最后,患有IBD的妇女在怀孕期间也有更多的产前检查,并且更有可能在妊娠早期接受产前检查。结论:妊娠期和产后IBD患者对医疗保健的利用有所增加。在此期间,应努力增加门诊服务,这反过来又可能减少这种保健服务的利用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Differences in Healthcare Utilization in Women with and without Inflammatory Bowel Diseases During Preconception, Pregnancy and Postpartum: A Population-Based Cohort Study.

Background and aims: Compared to those without inflammatory bowel disease [IBD], women with IBD may have increased healthcare utilization during pregnancy and postpartum, though this remains to be confirmed. We aimed to characterize this healthcare use between these groups.

Methods: Administrative databases were accessed to identify women [aged 18-55 years] with and without IBD who had a live, singleton pregnancy between 2003 and 2018. Differences in emergency department [ED] visits, hospitalizations and prenatal care during 12 months preconception, pregnancy and 12 months postpartum were characterized. Multivariable negative binomial regression was performed to report incidence rate ratios [IRRs] with 95% confidence intervals [95% CIs]. Covariates included maternal age at conception, location of residence, socioeconomic status and maternal comorbidity.

Results: In total, 6163 women with IBD [9158 pregnancies] and 1091 013 women without IBD [1729 411 pregnancies] were included. Women with IBD were more likely to visit the ED [IRR 1.13, 95% CI 1.08-1.18] and be hospitalized [IRR 1.11, 95% CI 1.01-1.21] during pregnancy, and visit the ED [IRR 1.21, 95% CI 1.15-1.27] and be hospitalized [IRR 1.18, 95% CI 1.05-1.32] during postpartum. On unadjusted analysis, women with IBD were more likely to be hospitalized for venous thromboembolic events. There was no difference in healthcare use in preconception. Finally, women with IBD also had a greater number of prenatal visits during pregnancy and were more likely to receive a first-trimester prenatal visit.

Conclusion: Women with IBD have increased healthcare utilization during pregnancy and postpartum. Efforts should be made to increase ambulatory care access during this period, which in turn may reduce this health-services utilization.

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来源期刊
Journal of Crohns & Colitis
Journal of Crohns & Colitis 医学-胃肠肝病学
CiteScore
15.50
自引率
7.50%
发文量
1048
审稿时长
1 months
期刊介绍: Journal of Crohns and Colitis is concerned with the dissemination of knowledge on clinical, basic science and innovative methods related to inflammatory bowel diseases. The journal publishes original articles, review papers, editorials, leading articles, viewpoints, case reports, innovative methods and letters to the editor.
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