Perianal Crohns disease results in fewer pregnancies but is not exacerbated by vaginal deliveryReportar como inadecuado

Perianal Crohns disease results in fewer pregnancies but is not exacerbated by vaginal delivery - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

* Corresponding author 1 Service de Gynécologie et Obstétrique Rennes 2 Foie, métabolismes et cancer 3 Service des Maladies de l-Appareil Digestif 4 UR1 - Université de Rennes 1

Abstract : Background Despite a high prevalence of Crohn-s disease in women of childbearing age, disease-related factors that may impact fertility and perianal Crohn-s disease after delivery remain unclear. Methods Self-administered questionnaires related to childbirth were completed by women with Crohn-s disease referred to a single gastroenterology unit. A survival analysis was performed for statistical purposes. Results A total of 184 patients were assessed, including 63 nulliparous women. The cumulative probabilities of having a child were 30%, 51% and 72% at the ages of 25, 30 and 35 years, respectively. Women with colonic disease, prior abdominal surgery and perianal disease were less likely to experience childbirth. After a median follow-up of 165 weeks post-delivery, the cumulative probabilities of fistulizing perianal Crohn-s disease occurrence were 8%, 12% and 21% at 1, 2 and 5 years following childbirth, respectively. Contrary to a prior history of perianal Crohn-s disease and colonic location, mode of delivery was not associated with perianal fistula. An episiotomy in the group of women with prior anal lesions did not result in a higher rate of fistula recurrence. Conclusion Perianal Crohn-s disease is associated with fewer pregnancies, however perianal fistulas were less affected by obstetric events than their own natural history.

Keywords : Pregnancy perianal Crohn-s disease deliveries Crohn-s Disease

Autor: Amélie Grouin - Charlène Brochard - Laurent Siproudhis - Jean Lévêque - Jean-François Bretagne - Patrice Poulain - Guillaume



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