Conception and pregnancy outcome in women with inflammatory bowel disease: A multicentre study from Japan

Abstract

In Japanese UC patients, conception and pregnancy outcomes after disease onset were comparable to the outcomes observed prior to disease onset, whereas CD appeared to be associated with adverse outcomes. Caesarean operation and LBW were more frequently observed in CD patients who had a history of surgery for perianal lesions and bowel resection.

Extent of disease is a major outcome predictor in patients with ulcerative colitis and pregnancy

“…Caesarean section was the mode of delivery in 14 of the 43 (33 %) patients in our study; 45 % of the patients in the pancolitis group underwent a Caesarean section as compared to 19 % in group II. Unlike other studies [2,11], our data failed to show a statistically significant higher frequency of Caesarean section in patients with pancolitis but this is likely to be a type II error related to the small sample size. Similarly, disease relapse was more common in the pancolitis group where it was observed in 11 of the 22 (50 %) patients vs. 14 % in group I.…”

“…Thus, the clinical scenario of IBD and pregnancy being present together in a patient is not uncommon. Some studies have shown that IBD is associated with a threefold increase in the risk of preterm delivery and two-to ninefold increase in the risk of low birth weight (LBW) infants [2]. Additionally, a four-to sixfold increase in the fetal growth restriction, i.e.…”

Inflammatory bowel disease and pregnancy

“…The risk of congenital abnormalities in the offspring of women suffering from inflammatory bowel disease is the same as in the general population [15,18,20]. In the aforementioned Mahadevan study, the authors did not observe a difference in the congenital malformation rate between women with colitis ulcerosa and Crohn's disease [16].…”

“…Previous infertility treatment increases the risk of miscarriage. History of intestinal surgery is an independent risk factor for low birth weight or cesarean delivery [15]. Mahadevan et al performed a cohort study comparing obstetric outcomes in IBD and IBD-free patients.…”

Immunogenetic contributions to recurrent pregnancy loss

“…Those with celiac disease and Crohn's/ulcerative colitis can also have autoimmune responses, which lead to early pregnancy loss. Those with SLE, inflammatory bowel disease, and autoimmune thyroiditis have a statistically significant increased risk of RPL (odds ratio 1.7-5.3) compared to their controls [16][17][18]. Other abnormal labs can place the patient at risk for RPL.…”