目的: 分析炎症性肠病(inflammatory bowel diseases，IBD)病例妊娠前、妊娠期及哺乳期的临床特点。方法: 收集2011年9月至2022年6月北京大学第三医院产科收治的妊娠合并IBD并分娩的病例资料，回顾分析其临床特点；按照妊娠前、妊娠期及哺乳期的疾病状态分为疾病活动组和缓解组，比较两组妊娠前咨询、营养状况、妊娠及分娩并发症、分娩孕周、分娩方式及新生儿结局。结果: 共纳入妊娠合并IBD 33位，其中7位分娩二胎，共40例分娩，包括自然受孕36例(90.0%)和辅助生殖4例(10.0%)。40例分娩中，妊娠前、妊娠期及哺乳期IBD持续处于缓解期21例(52.5%)，活动期19例(47.5%)，其中8例(42.1%)因自行停用药物或未按医嘱规律服药疾病发生活动。疾病缓解组与活动组相比，妊娠前咨询率更高(57.1% vs. 15.8%，P=0.010)，血红蛋白[(112.67±8.53) g/L vs. (102.84±5.23) g/L，P＜0.001]、血清总蛋白[(66.58±6.34) g/L vs. (60.83±6.25) g/L，P=0.006]、血清白蛋白[36.4(35.1，38.3) g/L vs. 34.3(31.1，35.6) g/L，P=0.006]、血钙[(2.25±0.10) μmol/L vs. (2.13±0.15) μmol/L，P=0.004]水平更高，妊娠期高血压疾病发生率更低(0 vs. 31.6%，P=0.007)。40例中经阴道分娩27例(67.5%)，剖宫产13例(32.5%)。新生儿结局分析结果表明，足月产38例，早产2例；巨大儿1例，小于胎龄儿1例，低出生体重儿1例，出生缺陷3例；转入新生儿重症监护病房10例，其中新生儿感染4例，新生儿黄疸2例。结论: 妊娠前咨询和评估对IBD患者至关重要，经过妊娠期精细管理，大多数病例可以得到良好的妊娠结局。

Objective: To analyze the clinical characteristics of patients with inflammatory bowel diseases (IBD) in pre-pregnancy, pregancy and loctation. Methods: The clinical data of pregnancy complicated with IBD in Department of Obstetrics and Gynecology of Peking University Third Hospital and deli-very from September 2011 to June 2022 were collected. The clinical characteristics of the patients were analyzed retrospectively. According to the state of diseases during pre-pregnancy, pregnancy and lactation, the patients were divided into active and remission group, and the two groups were compared interms of pre-pregnancy counseling, nutritional status, pregnancy and delivery complications, gestational week, mode of delivery, and neonatal outcome. Results: A total of 33 pregnant women with IBD were included in this study, of which 7 delivered a second child, for a total of 40 deliveries, with 36 natural pregnancies (90.0%) and 4 assisted reproductions (10.0%). Among the 40 cases, 21 cases (52.5%) were sustained in remission in pre-pregnancy, pregnancy and lactation, and 19 cases (47.5%) in disease activity, of which 8 cases (42.1%) were due to self-withdrawal of drugs or failure to take medicine regularly. Compared with the activity group, the disease remission group had a higher rate of pre-pregnancy counseling (57.1% vs. 15.8%, P=0.010), and higher levels of hemoglobin [(112.67±8.53) g/L vs. (102.84±5.23) g/L, P < 0.001], serum total protein [(66.58±6.34) g/L vs. (60.83±6.25) g/L, P=0.006], serum albumin [36.4 (35.1, 38.3) g/L vs. 34.3 (31.1, 35.6) g/L, P=0.006], serum calcium [(2.25±0.10) μmol/L vs. (2.13±0.15) μmol/L, P=0.004], but a lower incidence of gestational hypertensive disorders (0 vs. 31.6%, P=0.007). In 40 deliveries, there were 27 cases of vaginal delivery (67.5%), 13 cases of cesarean section (32.5%). The analysis of neonatal outcomes showed 38 full-term deliveries and 2 preterm deliveries; 1 case of macrosomia, 1 case of small-for-gestational-age, 1 case of low birth weight and 3 cases of birth defects. There were 10 newborns admitted to neonatal intensive care unit, including 4 cases of neonatal infections and 2 cases of neonatal jaundice. Conclusion: Pre-pregnancy counseling and evaluation of IBD patients are very important, and good pregnancy outcomes can be obtained through careful management during pregnancy in the most of the patients.