Birth Outcomes in Women with Inflammatory Bowel Disease

Bröms, Gabriella; Granath, Fredrik; Linder, Marie; Stephansson, Olof; Elmberg, Maria; Kieler, Helle

doi:10.1097/mib.0000000000000060

Cited by 115 publications

(155 citation statements)

References 28 publications

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“…33 We found no absolute or relative increase in the risk of perinatal death, similar to the meta-analysis that found no difference in the rates of stillbirths in women with IBD, 33 which was different from the large Swedish study that found that women with CD had an increased risk of stillbirth. 11 This highlights the difficulty of comparing studies from different time periods and countries, as women may have had different disease management before or during pregnancy, which may explain the differences in outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…30 An association with increased disease activity in CD and preterm birth has previously been reported 31 as has an association between UC and preterm birth, and between CD and stillbirth and particularly when there were flares throughout pregnancy. 11 There is slight uncertainty regarding the inclusion of women with the first record of IBD diagnosis after birth in the study. There were 151 (5.4%) women with a first record of IBD in the 6 months after delivery.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

“…10 A subsequent Swedish population-based study found that women with IBD had higher rates of preterm birth and low birthweight and that women with CD were at greater risk of stillbirth, particularly if they had active disease during pregnancy. 11 The aim of our study was to determine the frequency of IBD in a contemporary population of pregnant women and to determine the maternal and fetal/neonatal outcomes of women with IBD.…”

Section: Introductionmentioning

confidence: 99%

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Inflammatory bowel disease in pregnancy: a population‐based study of prevalence and pregnancy outcomes

Shand

Chen

Selby

et al. 2016

BJOG

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Objective To determine the prevalence of the inflammatory bowel diseases (IBD), ulcerative colitis (UC) and Crohn's disease (CD), in pregnant women and determine pregnancy and fetal/neonatal outcomes.Design Population-based cohort study.Setting New South Wales, Australia, 2001-11.Population A total of 630 742 women who delivered at ≥20 weeks of gestation.Methods Descriptive and multivariate regression analyses of perinatal data linked to hospital admission data. We compared birth outcomes of women with and without a documented diagnosis of IBD.Main outcome measures Caesarean section, severe maternal morbidity, preterm birth <37 weeks of gestation, planned preterm birth, small-for-gestational-age (birthweight <10th centile), perinatal mortality (stillbirth/neonatal death ≤28 days).Results In all, 1960 women (0.31%) with IBD, who had 2781 births (1183 UC, 1287 CD and 311 IBD-indeterminate). Women with IBD were more likely than women without IBD to have a caesarean section [41.5 versus 28.2%, adjusted risk ratio (aRR) 1.38, 95% CI 1.31-1.45], severe maternal morbidity (2.6 versus 1.6%, aRR 1.54, 95% CI 1.17-2.03), preterm birth (9.7 versus 6.6%, aRR 1.47, 95% CI 1.30-1.66), planned preterm birth (5.3 versus 2.9%, aRR 1.74, 95% CI 1.47-2.07), and their infants to be small-for-gestational-age (9.7 versus 9.5%, aRR 1.19, 95% CI 1.04-1.36). There was no evidence of a difference in perinatal mortality.Conclusion Pregnancy-associated IBD is more common than previously reported. Pregnancies complicated by IBD at or near the time of birth have significantly higher rates of adverse pregnancy outcomes than pregnancies of women without IBD.Keywords Crohn's disease, inflammatory bowel disease, population-based, pregnancy, ulcerative colitis.Tweetable abstract Increased rates preterm birth and caesarean section in women with inflammatory bowel disease.Please cite this paper as: Shand AW, Chen JS, Selby W, Solomon M, Roberts CL. Inflammatory bowel disease in pregnancy: a population-based study of prevalence and pregnancy outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Strengths and Limitationsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Inflammatory bowel disease in pregnancy: a population‐based study of prevalence and pregnancy outcomes

Shand

Chen

Selby

et al. 2016

BJOG

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“…Adequate disease control is crucial to ensure the best fetal and maternal health, since high disease activity is associated with an increased risk of adverse pregnancy outcomes [9][10][11][12][13]. Anti-TNF agents provide an effective therapeutic option, however, they are often discontinued during the early stages of pregnancy to limit potential in utero exposure of the fetus and to reduce the risk of congenital malformations during organogenesis [14][15][16].…”

Section: Introductionmentioning

confidence: 99%

Improving The Sensitivity and Specificity of A Bioanalytical Assay for The Measurement of Certolizumab Pegol

2017

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Aim:In order to evaluate placental transfer of certolizumab pegol (CZP), a more sensitive and selective bioanalytical assay was required to accurately measure low CZP concentrations in infant and umbilical cord blood. Results & methodology: A new electrochemiluminescence immunoassay was developed to measure CZP levels in human plasma. Validation experiments demonstrated improved selectivity (no matrix interference observed) and a detection range of 0.032-5.0 μg/ml. Accuracy and precision met acceptance criteria (mean total error ≤20.8%). Dilution linearity and sample stability were acceptable and sufficient to support the method. Conclusion: The electrochemiluminescence immunoassay was validated for measuring low CZP concentrations in human plasma. The method demonstrated a more than tenfold increase in sensitivity compared with previous assays, and improved selectivity for intact CZP.

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“…Preterm delivery and low birth weight was common in the CD cohort compared to pregnant women without CD. In a Swedish cohort of 1,220 births in women with CD, an increased risk of adverse birth outcomes, such as stillbirth, growth restriction, and preterm birth, were noted particularly in those who suffered from flares throughout pregnancy [142].…”

mentioning

confidence: 99%

Indian Society of Gastroenterology consensus statements on Crohn’s disease in India

Ramakrishna

Makharia

Ahuja

et al. 2015

Indian J Gastroenterol

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In 2012, the Indian Society of Gastroenterology's Task Force on Inflammatory Bowel Diseases undertook an exercise to produce consensus statements on Crohn's disease (CD). This consensus, produced through a modified Delphi process, reflects our current recommendations for the diagnosis and management of CD in India. The consensus statements are intended to serve as a reference point for teaching, clinical practice, and research in India.

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Birth Outcomes in Women with Inflammatory Bowel Disease

Abstract: Women with UC and CD are at increased risk of adverse birth outcomes, such as stillbirth, growth restriction, and preterm birth, particularly when they suffer from flares throughout pregnancy. Thiopurine exposure seems to further increase risks, independently of disease activity.

Cited by 115 publications

References 28 publications

Inflammatory bowel disease in pregnancy: a population‐based study of prevalence and pregnancy outcomes

Inflammatory bowel disease in pregnancy: a population‐based study of prevalence and pregnancy outcomes

Improving The Sensitivity and Specificity of A Bioanalytical Assay for The Measurement of Certolizumab Pegol

Indian Society of Gastroenterology consensus statements on Crohn’s disease in India

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