Postpartum surgical complications in women with inflammatory bowel disease after caesarian section: A Danish nationwide cohort study
| Autor: | Floor Dijkstra Zegers, Bente Mertz Nørgård, Line Riis Jølving, Jan Nielsen, Sonia Friedman |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: |
medicine.medical_specialty
Denmark Inflammatory bowel disease Danish Cohort Studies Colon surgery Pregnancy medicine Humans Obstetrics Vaginal delivery business.industry Cesarean Section Postpartum Period Gastroenterology General Medicine Odds ratio medicine.disease Inflammatory Bowel Diseases Cesarean Section/adverse effects Inflammatory Bowel Diseases/complications language.human_language Denmark/epidemiology language Population study Female Caesarian section business Cohort study |
| Zdroj: | Friedman, S, Zegers, F D, Jølving, L R, Nielsen, J & Nørgård, B M 2022, ' Postpartum surgical complications in women with inflammatory bowel disease after caesarian section: A Danish nationwide cohort study ', Journal of Crohn's and Colitis, vol. 16, no. 4, pp. 625-632 . https://doi.org/10.1093/ecco-jcc/jjab187 |
| Popis: | Background and Aims Our aim is to determine the 30-day postpartum surgical complications in women with inflammatory bowel disease [IBD] who undergo a caesarian section rather than a vaginal delivery. Methods Using the Danish national registries, we established a study population of liveborn singleton births from January 1, 1997, through December 2015. We examined all mothers with IBD who had a caesarian section or a vaginal delivery. We examined 30-day maternal postpartum abdominal and perineal surgical outcomes and adjusted for multiple confounders. We examined acute versus elective caesarian sections and the effect of immunosuppressive therapies on outcomes. Results In women with IBD, 2.1% undergoing caesarian section [n = 3255] versus 0.3% undergoing vaginal delivery [n = 6425] had a surgical complication. Women with IBD who had a caesarian section were more likely to have small bowel and colon surgery (adjusted odds ratio [aOR] 5.00, 95% confidence interval [CI] 2.00–12.51). Similar results were found regardless of acute [aOR 4.51, 95% CI 1.48–13.76] or elective [aOR 6.52, 95% CI 2.45–17.33] caesarian section. The risk of surgery after caesarian section was increased regardless of immunosuppressive use [aOR with immunosuppressives 8.79, 95% CI 2.86–27.05; and aOR without immunosuppressives 4.49, 95% CI 1.74–11.58]. Conclusions The risk of a surgical complication after caesarian section as compared with a vaginal delivery is increased in women with IBD, regardless of whether the caesarian is performed for acute or elective reasons and/or of immunosuppressive use before delivery. Due to this increased risk, physicians should perform a caesarian delivery as the exception rather than the rule. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|