Authors: Bush, MC; Patel, S; Lapinski, RH; Stone, JL

Source: Journal of Maternal-Fetal and Neonatal Medicine, Volume 15, Number 4, April 2004 , pp. 237-241(5)

Publisher: Informa Healthcare

Abstract:

Objective: To determine whether inflammatory bowel disease (IBD) is associated with increased risk for adverse perinatal outcome.

Methods: A case-control study of 116 singleton pregnancies with IBD compared to 56 398 singleton controls delivered between 1986 and 2001.

Results: Patients with IBD were slightly older (32.8 vs. 30.6 years, p < 0.001), more likely to be Caucasian or Asian than Black or Latino (92% vs. 57%, p < 0.001) and have private health insurance (33% vs. 3%, p < 0.001). IBD was associated with an increased risk for labor induction (32% vs. 24%, p = 0.002), chorioamnionitis (7% vs. 3%, p = 0.04) and Cesarean section (32% vs. 22%, p = 0.007), but there were no differences in neonatal outcomes. Subgroup analysis demonstrated an increased risk for low birth weight (LBW) in the ulcerative colitis group vs. the Crohn's disease group (19% vs. 0%, p = 0.002). Patients with prior surgery for IBD had a lower incidence of LBW (0% vs. 12%, p = 0.03). Flares during pregnancy were associated with an increased risk for preterm delivery (27% vs. 8%, p = 0.02) and LBW (32% vs. 3%, p = 0.003).

Conclusion: IBD was an independent risk factor for Cesarean section but there was no increase in adverse perinatal outcome. Crohn's disease, prior IBD surgery and quiescent disease were associated with a lower risk for LBW.

Keywords: INFLAMMATORY BOWEL DISEASE; ULCERATIVE COLITIS; CROHN'S DISEASE; PREGNANCY; LOW BIRTH WEIGHT; CESAREAN SECTION

Document Type: Research article

DOI: http://dx.doi.org/10.1080/14767050410001668662

Publication date: 2004-04-01

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