Obstetric outcomes of patients with inflammatory bowel disease

Introduction : Inflammatory bowel diseases (IBD) are frequently diagnosed between the ages of 20 and 40, i.e. the most fertile period for women. The potential impact of IBD on pregnancy is therefore a frequent issue. Study objective : To determine the impact of disease activity during pregnancy on the obstetric prognosis of women with IBD. Methods : Gastroenterological and obstetric data were collected for patients for all consecutive patients with IBD and pregnancy followed up at Amiens University Hospital (Amiens, France) between 2007 and 2021. Obstetrics outcome of patients with and without active disease were compared. Results : One hundred patients were included (81 with Crohn’s Disease for 198 pregnancies, 19 with Ulcerative Colitis for 37 pregnancies). Patients with active IBD (21 patients, 24 pregnancies) were more likely to be admitted to hospital during pregnancy (66.6%, vs. 5.2% in the inactive IBD group; p<0.001), to give birth prematurely (mean term: 36.77 weeks of amenorrhoea (WA) vs. 38.7 WA, respectively; p=0.02) and to experience very premature delivery (before 32 WA: 12.5% vs. 1.4%, respectively; p=0.02). Patients with active disease had a shorter term at birth (38.4 WA, vs. 39.8 WA in the inactive disease group; p<0.0001), a lower birth weight (2707 g vs. 3129 g, respectively; p=0.01) and higher caesarean section rate (54.2% vs. 16.9%, respectively; p=0.03). Conclusion : Women with IBD patients are at risk of pregnancy related complications, especially when IBD is active. Controlling disease activity at conception and close monitoring of the pregnancy is essential to improve both gastroenterological and obstetric outcome.