白塞病与妊娠

        来自以色列Jadaon J等发表在<< Acta Obstet Gynecol Scand.>> 2005年10月84(10):939-44.的研究报告

        Behçet's disease and pregnancy.Jadaon J, Sela HY, Ozcan C, Rojansky N.

        BACKGROUND: Behçet's disease (BD) is a multisystem inflammatory chronic disorder, which is characterized by relapsing oral and genital ulceration and iridocyclitis. While being of unknown etiology, vasculitic changes of possible autoimmune origin are common to all involved organs, and thrombotic complications, which may adversely affect gestation, are frequently seen. Very little is known to date about the reciprocal influence of BD and pregnancy. We have undertaken to explore the mutual effect of BD and pregnancy with emphasis on maternal and fetal complications.

        背景：白塞病是一种多系统的慢性炎性疾病，其特点是复发性口腔和生殖器溃疡及虹膜睫状体炎。发病原因不清楚，所有受累器官常有自身免疫诱发的血管炎改变，也常可见到血栓合并症，这可能对妊娠不利.有关白塞病与怀孕的相互影响资料很少，为此,我们进行了该项研究,以了解白塞病与怀孕的相互影响，重点强调对母亲和胎儿合并症的影响。

        METHODS: In this case-control study, we have evaluated pregnancies that occurred in women suffering from BD, who were treated in our institution during the last 25 years. All records were reviewed, and data were confirmed by a telephone interview and compared with a matched control group. To review the current knowledge, a Medline search together with a manual search of selected articles was performed.

        方法：在该病例对照研究中，我们评价了最近25年来我院治疗的女性白塞病患者的怀孕情况。所有资料均为回顾性的，并经过电话咨询得到证实，与对照组进行比较。我们同时进行了Medline检索及对部分文章进行了手工检索，来综述当前的一些知识。

        RESULTS: Thirty-one Behçet's patients who had 135 pregnancies were studied. Remissions were significantly more frequent during both pregnancy and postpartum periods, while exacerbations were observed only in one-sixth of the patients (P < 0.001). Pregnancy complications (P < 0.001), cesarean section (P < 0.001), and miscarriage (P < 0.02) rates, however, were significantly higher in the study group.

        结果:31例白塞病总共有135次怀孕，在怀孕期间和产后白塞病的病情缓解更为多见，仅有1/6的患者恶化（P〈0.001）。然而，研究组中有较高的妊娠合并症（P〈0.001）、剖宫产术（P〈0.001）和流产（P〈0.02）发生率。

        CONCLUSIONS: Our study suggests that pregnancy does not have a deleterious effect on the course of BD and may possibly ameliorate its course. However, it seems that BD may adversely affect pregnancy. The miscarriage rate was higher, and the pregnancy complications and cesarean section rates were significantly elevated.

        结论：我们的研究提示怀孕对白塞病本身无不良影响，还可能缓解病情，但白塞病似乎对怀孕有不好的影响，流产发生率较高，妊娠合并症和剖宫产比率明显增高。

        白塞病与对照组怀孕合并症比较

合并症	白塞病组（n = 77）(%)	对照组（n = 288）(%)
流产	16 (20.7)	19 (6.6)
高血压†	3 (3.8)	1 (0.3)
妊娠期糖尿病#	7(9.0)	2 (0.6)
早产‡	1 (1.2)	1 (0.3)
感染	2 (2.5)	0 (0.0)
胎膜早破*	1 (1.2)	0 (0.0)
血栓事件§	1 (1.2)	0 (0.0)
其他**	1 (1.2)	1 (0.3)

     注：#妊娠期糖尿病：6例A1型,1例A2型

    *胎膜早破：是在分娩开始前1小时即胎膜破裂

    ‡早产：孕37周前分娩

     §血栓事件：为深静脉血栓

     **其他：孕早期出血

TAG: 妊娠