inflammatory bowel disease in pregnancy

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A recent study determined particular risks that could be associated with inflammatory bowel disease in pregnancy.

Over 25% of patients diagnosed with Inflammatory bowel disease (IBD) become pregnant and face certain risks during pregnancy and delivery. A recent analysis of 53 previous studies was published in the journal Alimentary Pharmacology & Therapeutics and outlined increased risks.

According to the review, women with IBD had a higher risk of requiring a C-section. Among all pregnant patients with IBD, one-third underwent delivery by C-section. That represented an almost twofold increase compared to healthy women.

More than half of patients who underwent surgical delivery represented obstetrics or neonatal complications such as labour arrest and fetal heart rate problems, and around 13 percent had this mode of delivery due to expressed concerns of perineum damage.

In addition, according to the results of the study, patients with inflammatory bowel disease had a higher risk of gestational diabetes. Women with both disorders underwent surgical delivery three times more than the other women.

The study also reported that women with IBD had higher chances of preterm prelabour rupture of membranes.

On the contrary, although many auto-immune disorders are associated with a higher risk of placental-related conditions such as pre-eclampsia or placental abruption, researchers did not observe this in women with inflammatory bowel disease.

Non-biologic (5-ASA and thiopurines) and anti-TNF therapies that are usually used in the treatment of inflammatory bowel disease were not associated with any adverse pregnancy-related outcomes. These findings may support the recent guideline recommendation to continue treatment during pregnancy to maintain disease remission.

Further studies are needed to determine how the activity of inflammatory bowel disease affects outcomes and specific risks related to trimesters.

Written by Anna Otvodenko

References:

Tandon, P., Govardhanam, V., Leung, K., Maxwell, C. and Huang, V. (2020). Systematic review with meta-analysis: risk of adverse pregnancy-related outcomes in inflammatory bowel disease. Alimentary Pharmacology & Therapeutics, 51(3), pp.320-333.

EurekAlert!. (2020). Does inflammatory bowel disease carry certain risks during pregnancy?. [online] Available at: https://www.eurekalert.org/pub_releases/2020-01/w-dib010620.php [Accessed 28 Jan. 2020].

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