Association between maternal inflammatory bowel disease and adverse perinatal outcomes

• Published in: Journal of perinatology Vol. 34; no. 6; pp. 435 - 440
• Main Authors: Getahun, D, Fassett, M J, Longstreth, G F, Koebnick, C, Langer-Gould, A M, Strickland, D, Jacobsen, S J
• Format: Journal Article
• Language: English
• Published: New York Nature Publishing Group US 01-06-2014; Nature Publishing Group
• Subjects: 692/699/1503/1581/257; 692/700/1750/1747; Adult; Birth; California - epidemiology; Care and treatment; Cohort Studies; Colitis, Ulcerative - complications; Complications and side effects; Confidence intervals; Crohn Disease - complications; Female; Fetal Membranes, Premature Rupture - etiology; Health aspects; Humans; Incidence; Infant, Newborn; Infant, Small for Gestational Age; Infants (Premature); Inflammatory bowel disease; Inflammatory bowel diseases; Intestine; Ischemia; Medical records; Medicine; Medicine & Public Health; Membranes; Mothers; original-article; Patient outcomes; Pediatric Surgery; Pediatrics; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Premature birth; Premature Birth - etiology; Retrospective Studies; Risk Factors; Rupture; Small-for-gestational age; Ulcerative colitis; Young Adult; California
• ISSN: 0743-8346; 1476-5543
• DOI: 10.1038/jp.2014.41

Objective:
To examine whether inflammatory bowel disease (IBD) is associated with ischemic/inflammatory conditions during pregnancy.
Study Design:
A retrospective cohort study using the 2000 to 2012 Kaiser Permanente Southern California maternally-linked medical records (
n
=395 781). The two major subtypes of IBD, ulcerative colitis and Crohn’s diseases were studied. Adjusted odds ratios (ORs) were used to quantify the associations.
Result:
A pregnancy complicated by IBD was associated with increased incidence of small-for-gestational age birth (OR=1.46, 95% confidence interval (CI)=1.14 to 1.88), spontaneous preterm birth (OR=1.32, 95% CI=1.00 to 1.76) and preterm premature rupture of membranes (OR=1.95, 95% CI=1.26 to 3.02). Further stratifying by IBD subtypes, only ulcerative colitis was significantly associated with increased incidence of ischemic placental disease, spontaneous preterm birth and preterm premature rupture of membranes.
Conclusion:
The findings underscore the potential impact of maternal IBD on adverse perinatal outcomes. Clinicians should be aware that the association between IBD and adverse perinatal outcome varies by IBD subtypes.