'Excellent' birth outcomes for IBD patients, even with active disease

Last Updated: 2016-07-19

By Reuters Staff

NEW YORK (Reuters Health) - While past research has linked active inflammatory bowel disease (IBD) during pregnancy to spontaneous abortion, preterm birth and other adverse outcomes, "these outcomes do not seem representative in the era of biologicals," researchers say.

Their conclusions are drawn from a study of 229 women with IBD who had 298 pregnancies and 226 live births between 2008 and 2014.

"Birth outcomes were excellent, reflecting the stringent follow-up and treatment of this group of patients," Dr. Christien Janneke van der Woude of Erasmus University Medical Center in Rotterdam and colleagues reported online June 28 in the American Journal of Gastroenterology.

Women whose IBD is active when they conceive are more likely to have disease relapse during pregnancy, their research confirmed. And ulcerative colitis (UC) patients were more likely to relapse during pregnancy than Crohn's disease (CD) patients.

There were 157 women with CD and 66 with UC; the remaining six were unclassified.

Women with active disease at conception had an adjusted odds ratio (aOR) of 7.66 for disease relapse during pregnancy. UC patients were more likely to relapse, with an aOR of 3.71, independent of age, smoking, periconceptional disease activity, previous surgery for IBD, and use of immunosuppressants or anti-tumor necrosis factor.

There was no association between disease relapse and any adverse birth outcome, including spontaneous abortion, low birth weight, or preterm birth.

However, the authors point out, "in nulliparous IBD women, multivariate analysis showed that active disease is associated with spontaneous abortion, as well as low birth weight. This is in contrast to findings in the total group, suggesting that parity may be of influence when analyzing the effects of active disease on birth outcomes."

"Although IBD women with disease relapse during pregnancy had median lower birth weights compared to women without disease relapse, the effect of disease relapse on birth outcomes appears less deleterious than previously reported," the researchers state. "Diligent counseling and follow-up remain important in this delicate group of IBD patients."

Dr. van der Woude did not respond to an interview request by press time.

SOURCE: http://go.nature.com/29Ylt93

Am J Gastroenterol 2016.