Complications From Inflammatory Bowel Disease During Pregnancy and Delivery

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

doi:10.1016/j.cgh.2012.08.018

Cited by 69 publications

(78 citation statements)

References 36 publications

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“…[7][8][9] A population-based study from Sweden showed that women with IBD had twice the rate of caesarean section compared with control women, and that women with UC had increased rates of venous thromboembolism (VTE). 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%

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: Introductionmentioning

confidence: 99%

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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“…VTE is increased in women with UC, while antepartum hemorrhage risk is more prevalent in women with CD [47] . There is nearly a 4-fold increase in the risk of VTE in women with UC; while CD affects women have a risk of VTE that was comparable with the general population [47] . The antepartum hemorrhage risk is shown to be doubled in women with CD [47] .…”

Section: Pregnancymentioning

confidence: 96%

“…There is nearly a 4-fold increase in the risk of VTE in women with UC; while CD affects women have a risk of VTE that was comparable with the general population [47] . The antepartum hemorrhage risk is shown to be doubled in women with CD [47] . Approximately 2% of women with CD and UC were seen to develop placental abruption in a study on obstetric hospitalizations [49] .…”

Section: Pregnancymentioning

confidence: 99%

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Pregnancy and inflammatory bowel diseases: Current perspectives, risks and patient management

Hosseini‐Carroll¹,

Mutyala²,

Seth³

et al. 2015

WJGPT

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Manas K made critical revisions of the manuscript; Becker F and Alexander JS contributed equally as senior authors. Conflict-of-interest statement:There are no known conflicts of interest. The authors (Pegah Hosseini-Carroll, Monica Mutyala, Abhishek Seth, Shaheen Nageeb, Demiana Soliman, Moheb Boktor, Ankur Sheth, Jonathon Chapman, James Morris, Paul Jordan, Kenneth Manas, Felix Becker, and J Steven Alexander) have no relevant financial considerations related to this proposal, and the study was not supported by any corporate entity. There is no known intellectual property associated with this report. AbstractInflammatory bowel diseases (IBD) are chronic idiopathic inflammatory conditions characterized by relapsing and remitting episodes of inflammation which can affect several different regions of the gastrointestinal tract, but also shows extra-intestinal manifestations. IBD is most frequently diagnosed during peak female reproductive years, with 25% of women with IBD conceiving after their diagnosis. While IBD therapy has improved dramatically with enhanced surveillance and more abundant and powerful treatment options, IBD disease can have important effects on pregnancy and presents several challenges for maintaining optimal outcomes for mothers with IBD and the developing fetus/neonate. Women with IBD, the medical team treating them (both gastroenterologists and obstetricians/gynecologists) must often make highly complicated choices regarding conception, pregnancy, and post-natal care (particularly breastfeeding) related to their choice of treatment options at different phases of pregnancy as well as post-partum. This current review discusses current concerns and recommendations for pregnancy during 157November 6, 2015|Volume 6|Issue 4| WJGPT|www.wjgnet.com Hosseini-Carroll P et al . Pregnancy and inflammatory bowel diseases IBD and is intended for gastroenterologists, general practitioners and IBD patients intending to become, (or already) pregnant, and their families. We have addressed patterns of IBD inheritance, effects of IBD on fertility and conception (in both men and women), the effects of IBD disease activity on maintenance of pregnancy and outcomes, risks of diagnostic procedures during pregnancy and potential risks and complications associated with different classes of IBD therapeutics. We also have evaluated the clinical experience using "top-down" care with biologics, which is currently the standard care at our institution. Post-partum care and breastfeeding recommendations are also addressed. Core tip: Inflammatory bowel diseases (IBD) are chronic inflammatory conditions characterized by relapsing and remitting episodes of intestinal inflammation. IBD is most frequently diagnosed during peak female reproductive years, with 25% of women with IBD conceiving after their diagnosis. While therapies have improved dramatically, IBDs have important effects on pregnancy and present challenges for maintaining optimal outcomes for mothers and their developing fetus/ neonate. Women with IBD and physician...

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“…Certain comorbidities have been associated with increased risk of VTE during pregnancy, including inflammatory intestinal disease, 39 urinary tract infection, 24 systemic lupus erythematosus, heart diseases, 19 systemic arterial hypertension induced by pregnancy or pre-eclampsia, 25,27 and non-obstetric prenatal surgery. 40 An analysis of data from 1,475,301 discharges from Scottish maternity units conducted by Kane et al 27 identified risk factors associated with VTE that included three or more previous pregnancies, obstetric hemorrhage, and pre-eclampsia.…”

Section: Other Risk Factorsmentioning

confidence: 99%

Profilaxia de tromboembolismo venoso na gestação

Oliveira¹,

Marques

2016

J. vasc. bras.

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Venous thromboembolism is a major cause of obstetric morbidity and mortality. During pregnancy, the risk of occurrence increases between five and ten times when compared to women of the same age who are not pregnant. Compounding this is the fact that pregnant women present certain characteristics that make diagnosis more difficult using clinical signs (high frequency of pain and swelling in the lower limbs), echographic examination (lower sensitivity and specificity for diagnosis of iliac vein thrombosis as pregnancy progresses), and laboratory findings (D-dimer levels progressively increase throughout pregnancy). Conducting careful stratification of women' s venous thromboembolism risk before pregnancy could reduce the incidence of this disease, which is frequent and difficult to diagnose during pregnancy, and of its complications.Keywords: venous thrombosis; prophylaxis; pregnancy. ResumoO tromboembolismo venoso é importante causa de morbidade e mortalidade obstétrica. Durante a gestação, o risco de sua ocorrência aumenta entre cinco e dez vezes quando comparado ao de mulheres não gestantes de mesma idade. Associado a esse fato, a gestante apresenta algumas limitações para o diagnóstico clínico (alta frequência de dor e edema nos membros inferiores), ecográfico (menor sensibilidade e especificidade no diagnóstico de trombose venosa de ilíaca com a evolução da gestação) e laboratorial (o D-dímero apresenta aumento progressivo no decorrer da gravidez). Uma estratificação criteriosa de risco de tromboembolismo venoso de cada mulher antes da gestação pode diminuir a incidência dessa doença, frequente e de difícil diagnóstico na gravidez, e suas complicações.

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Complications From Inflammatory Bowel Disease During Pregnancy and Delivery

Cited by 69 publications

References 36 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

Pregnancy and inflammatory bowel diseases: Current perspectives, risks and patient management

Profilaxia de tromboembolismo venoso na gestação

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