Pregnancy outcome in women with inflammatory bowel disease according to the activity of the disease and the drug treatment

Introduction: Inflammatory bowel diseases (IBD-Crohn's disease [CD]; ulcerative colitis [UC]) affect young adults in their reproductive ages. According to literature data, women with IBD, even with inactive disease and low risk medications are at increased risk for adverse pregnancy outcome compared to women without IBD.

Aims: The aim of our study was to assess whether disease activity and medical treatment of IBD during the pregnancy affect the outcomes and complications of pregnancy in women with CD and UC.

Patients and methods: 64 pregnancies in women with IBD (20 CD; average age at delivery: 27.5 [20–40] years and 44 with UC; average age at delivery: 28.4 [21–38] years) were included in our study. Influence of disease activity and medical treatment during the pregnancies on gestational age, birth height and weight and health state of newborn infants and the children nowadays were statistically analyzed. P values lower than 0.05 were considered statistically significant.

Results: Our results did not reveal relationship between any type of drug treatment for IBD and serious adverse outcome of pregnancies both in CD and UC. Considering normal outcomes (healthy infants) in the UC group, significantly greater number of women was treated continuously during their pregnancies than in case of abnormal outcomes. No significant increase in serious adverse outcomes related to disease activity was found, only reduced birth height of the infants was detected more frequently in CD. Disease activity did have an effect only on the late growth of children in case of active maternal UC.

Conclusion: Although literature data suggest that women with IBD are more likely to have an adverse outcome related to pregnancy, disease activity and medical treatment did not predict serious adverse outcomes in our study, except for reduced birth length in CD.