베체트병이 합병된 임신에서 산모와 태아의 예후
The outcome of pregnancy complicated by Behçet’s disease
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목적: 본 연구는 베체트병이 합병된 임신에서 산모와 태아의 예후에 관하여 알아보고자 하는 것이다. 연구 방법: 1991년 5월부터 2007년 7월까지 본원에서 베체트병으로 진단된 39명의 산모와, 같은 기간 동안 무작위 추출된 499명의 정상 산모를 대상으로 후향적으로 의무기록을 분석하여 연구되었다. 전신성홍반성루프스 또는 류마티스관절염과 같은 다른 결체조직 질환과 고혈압, 당뇨와 같은 내과적 질환이 동반된 경우는 본 연구에서 제외되었다. 결과: 베체트병이 합병된 임신에서의 예후와 정상 임신에서의 예후를 연구하기 위해 산모의 나이, 산과력, 유산율, 분만주수, 제왕절개술여부, 조기양막파수 여부, 조산, 출생 시 체중, APGAR 점수, 자궁 내 태아사망률을 비교 분석하였다. 정상 산모에 비해 베체트병을 진단받은 산모에서 초산모의 비율이 더 많았고 (P<0.001), 1분 APGAR 점수가 4점 이하인 경우 (P<0.005)와 5분 APGAR 점수가 7점 이하인 경우 (P<0.039)가 더 빈번하게 나타났으며, 자궁내 태아사망의 발생빈도가 유의하게 (P<0.001) 증가됨을 확인하였고, 기타 산과적 합병증은 차이가 없었다. 결론: 베체트병은 산모와 태아에게 부정적 영향을 줄 가능성이 있으므로, 베체트병으로 진단된 여성이 임신을 원하는 경우 더욱 주의 깊은 임신 전 상담이 필요하며, 임신 후에는 좀 더 적극적인 산전진찰이 필요하다고 할 수 있을 것이다.
Abstract
Objective: The aim of this study is to investigate the effects of Behçet’ disease (BD) on pregnancy outcome. Methods: We evaluated pregnancies in women who had been diagnosed as BD prior to pregnancy. The medical records of 39 pregnancies in 27 women from May, 1991 to July, 2007 with underlying BD and 499 randomly selected normal pregnancies not associated with BD were retrospectively reviewed. Women with other connective tissue disorders like systemic lupus erythematosus or rheumatoid arthritis and medical illnesses such as diabetes mellitus or hypertension were excluded from the study. The statistical significance was defined as P<0.05. Results: The influence of BD on pregnancy and its outcome were studied in comparison with the normal group. The age, parity, spontaneous abortion rates, delivery weeks, cesarean section rates, premature rupture of membranes, preterm birth, fetal birth weights, APGAR scores, and intrauterine fetal death were compared. Majority of the women with BD were primiparae (P<0.001), and intrauterine fetal death rates (P<0.001) were significantly higher in the study group. The 1-minute APGAR score (P<0.005) of 4 or less and 5-minute APGAR score (P<0.039) of 7 or less appeared more in Behçet’ group. The incidences of pregnancy complications including spontaneous abortion, premature rupture of membranes, preterm birth, and small for gestational age did not show statistically significant differences between the two groups. Conclusion: The results show higher rates of primiparity, lower APGAR scores, and higher intrauterine fetal death rates in patients with BD which implies that the disease may adversely affect pregnancy. Therefore, it is important for pregnant women with BD to receive proper antenatal care and preconception counseling prior to pregnancy.
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