Pregnancy Outcomes in Women With Inflammatory Bowel Disease: A Large Community-Based Study From Northern California

Management of inflammatory bowel disease in pregnancy

“…A similar finding was seen among CD patients [28]. A large northern California population-based cohort study of 461 pregnant IBD patients showed the majority of patients with UC and CD had inactive or mild disease throughout pregnancy (65-80% based on the pregnancy stage) [29].…”

“…Flares had previously been thought to occur most often in the first trimester and in the postpartum period, but this may have been confounded by women discontinuing their medications early in pregnancy and resuming smoking postpartum. The northern California cohort study demonstrated that the rate of flares was low and similar throughout pregnancy and the postpartum period [29].…”

“…There has been a large volume of literature to suggest that women with IBD are at increased risk of pregnancy complications compared with age-matched non-IBD peers [29,38,41,[46][47][48]. In concordance with these prior findings are two recent Scandinavian population-based studies conducted by Stephansson et Molnár et al looking at pregnancies of UC and CD patients before and after IBD diagnosis (70 and 97 pregnancies, respectively) also concluded that preterm birth (p = 0.008) and low birthweight (p = 0.048) were more common after the diagnosis of IBD [50].…”

“…There was reportedly no difference in pregnancy outcomes depending on location or extension of disease, perianal complications, surgery or type of delivery. Additionally, a 2007 northern California cohort study found increased rates of spontaneous abortion and pregnancy complications such as eclampsia/ preeclampsia, abruption placenta, fetal distress, placenta previa and prolonged/premature rupture of membranes [29].…”

Gestational Weight Gain: A New Factor Influencing Pregnancy Outcomes in Women with Inflammatory Bowel Disease

“…Increased disease activity during pregnancy, which is particularly worrisome, is linked to preterm birth [2]. Multiple studies of immunosuppressive medication use during pregnancy have reported that thiopurines and biologic therapies have no impact on birth outcomes [3,4]. Nevertheless, is it only increased disease activity that physicians and patients need to be wary of?…”