Dig Dis Sci:分娩方式不影响炎症性肠病的风险

2021-02-08 MedSci原创 MedSci原创

以克罗恩病(CD)和溃疡性结肠炎(UC)为主的炎症性肠病(IBD)是胃肠道相关的慢性复发-缓解型炎症性疾病。

      以克罗恩病(CD)和溃疡性结肠炎(UC)为主的炎症性肠病(IBD)是胃肠道相关的慢性复发-缓解型炎症性疾病。最近的流行病学证据表明,发展中国家疾病的发病率和患病率正在增加。加拿大的一项基于人群的分析发现,0-5岁儿童的IBD显着增加,而6岁以上儿童的IBD发病率保持稳定,分娩方式是早期生命中最重要的暴露之一,也是新生儿肠道定植的主要决定因素。阴道出生的婴儿的微生物群组成更接近其母亲的阴道和肠道微生物群,而通过剖腹产分娩的婴儿的微生物群组成与母体皮肤和医院环境更为相似。因此,由于出生时肠道定植改变,剖腹产也可能导致更高的IBD风险,在此,本项研究的目的是评估(1)与阴道分娩相比,剖腹产所致IBD的总体风险;(2)与阴道分娩相比,剖宫产所生的CD和UC的风险分别与(3)急诊和选择性剖宫产出生的患者发生IBD的风险差异。

 

 

      研究人员对数据库中所有与IBD和分娩相关的文献进行了搜索,主要观察结果是与经剖腹产相比,阴道分娩的人发生IBD的风险。次要结局是根据分娩方式而定的UC和CD风险,以及与选择性剖宫产相比由急诊出生的人的IBD风险。

 

 

      最后总共有十项研究符合纳入标准,其中七项基于人群。总体上,包括14164名IBD患者和4206763对照。通过剖腹产出生与总IBD [OR 1.01,95%CI(0.81–1.27),p = 0.92]发生风险无关,同时与CD [OR 1.15,95%CI(0.94–1.42),p = 0.18]和UC [OR 0.94,95%CI(0.61-1.45),p = 0.79]的发生风险无关。在IBD中,急诊剖宫产和选择性剖宫产对于IBD发生风险也无差异[OR 1.05,95%CI(0.59-1,87),p= 0.87]。

 

 

      总之,剖腹产与CD或UC的IBD发生风险均不相关。剖腹产的类型(选择性或急诊)未发现差异。尽管剖腹产与早期生命中的微生物群改变有关,但这些差异似乎在出生后第一年就消失了,这表明仅剖腹产并不是IBD风险的围产期的危险因素

 

 

 

原始出处:

Catarina Frias Gomes. Et al. Mode of Delivery Does Not Affect the Risk of Inflammatory Bowel Disease. Digestive Diseases and Sciences.2021.

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    2021-09-18 zhaojie88
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    2021-02-10 linlin2312
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