Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Feb;57(3):335-344.
doi: 10.1111/apt.17348. Epub 2022 Dec 14.

Predictors of disease activity during pregnancy in women with inflammatory bowel disease-a Danish cohort study

Thea Vestergaard  1   2 , Mette Julsgaard  1   2   3 , Julie F Røsok  1 , Søren V Vestergaard  2   4 , Rikke B Helmig  5 , Sonia Friedman  6 , Jens Kelsen  1
Affiliations

Predictors of disease activity during pregnancy in women with inflammatory bowel disease-a Danish cohort study

Thea Vestergaard et al. Aliment Pharmacol Ther. 2023 Feb.

Abstract

Background and aims: Inflammatory bowel disease (IBD) activity during pregnancy is associated with adverse pregnancy outcomes. We aimed to identify key clinical characteristics that predict disease activity during pregnancy.

Methods: Between January 2008 through 2021, we identified all singleton pregnancies among women with IBD recorded in patient and birth registries at a tertiary IBD centre in Denmark. Maternal and infant data were retrieved from medical records. Demographics, Physicians Global Assessment (PGA) of disease activity 6 months prior to pregnancy and in all three trimesters of pregnancy and pregnancy outcomes were recorded.

Results: In 609 pregnancies, we observed 603 (99.0%) live births. Disease activity in one or more trimesters was seen in 283 women (46.5%). UC phenotype was associated with an increase in risk of disease activity (adjusted OR = 2.6 [1.8-3.9]; p < 0.001). Disease activity within 6 months prior to conceiving (169 women [27.7%]) was associated with an increased risk of continuous disease activity during pregnancy (adjusted OR of 5.3 [3.5-8.2]; p < 0.001). Disease activity during a previous pregnancy was associated with an increased risk of flares in subsequent pregnancies (adjusted OR of 3.2 [1.5-6.6]; p = 0.002). Sustained clinical remission throughout pregnancy was associated with an increased probability of normal birth term, birthweight and low risk of fetal growth restriction (FGR) and stillbirth.

Conclusion: Predictors for disease activity include disease activity in a previous pregnancy and/or prior to conception, as well as UC phenotype. Reassuringly, women with IBD in remission are not at increased risk of adverse pregnancy outcomes.

Keywords: IBD; disease activity; pregnancy; risk factors.

PubMed Disclaimer

Comment in

References

REFERENCES

    1. Mahadevan U, Robinson C, Bernasko N, Boland B, Chambers C, Dubinsky M, et al. Inflammatory bowel disease in pregnancy clinical care pathway: a report from the american gastroenterological association ibd parenthood project working group. Gastroenterology. 2019;156:1508-24.
    1. Kim MA, Kim YH, Chun J, Lee HS, Park SJ, Cheon JH, et al. The influence of disease activity on pregnancy outcomes in women with inflammatory bowel disease: a systematic review and meta-analysis. J Crohns Colitis. 2021;15:719-32.
    1. Odufalu FD, Long M, Lin K, Mahadevan U, PIANO Investigators from the Crohn's and Colitis Foundation (CCF) Clinical Research Alliance Recruited Patients for their Respective Centers for Participant Enrollment. Exposure to corticosteroids in pregnancy is associated with adverse perinatal outcomes among infants of mothers with inflammatory bowel disease: results from the piano registry. Gut. 2022;71:1766-72.
    1. Rolston VS, Boroujerdi L, Long MD, McGovern DPB, Chen W, Martin CF, et al. The influence of hormonal fluctuation on inflammatory bowel disease symptom severity-a cross-sectional cohort study. Inflamm Bowel Dis. 2018;24:387-93.
    1. Nasef NA, Ferguson LR. Inflammatory bowel disease and pregnancy: overlapping pathways. Transl Res. 2012;160:65-83.

Publication types

LinkOut - more resources