Pregnancy Outcomes in Women With Inflammatory Bowel Disease: A Large Community-Based Study From Northern California

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Pregnancy Outcomes in Women With Inflammatory Bowel Disease: A Large Community-Based Study From Northern California

Uma Mahadevan, , , J. Sandborn‡, De–Kun Li§, Shahbaz Hakimian§, Sunanda Kane and A. Corley§ ‡Division of Gastroenterology, Department of Medicine, Mayo Clinic, Rochester, MinnesotaDivision of Gastroenterology, Department of Medicine, University of California San Francisco, San Francisco, CaliforniaDivision of Gastroenterology, Department of Medicine, University of Chicago, Chicago, Illinois§Division of Research, Kaiser Permanente, Oakland, California Received 25 April 2006; accepted 12 July 2007. Available online 25 July 2007. Background & Aims: The aim of this study was to determine whether pregnancy outcomes differ between women with and without inflammatory bowel disease (IBD) and to determine what risk factors adversely affect outcomes.

Methods: We conducted a cohort study of all pregnant women within the Northern California Kaiser Permanente membership between the years 1995 and 2002. We abstracted the records of all pregnancies in women with IBD (exposed cohort) and a random sample of pregnancies from age-matched women without IBD (unexposed cohort) and evaluated risk factors for spontaneous abortion, complications of pregnancy, and adverse newborn events.

Results: A total of 461 pregnant women with IBD were matched to 493 unexposed pregnant women. Women with IBD were more likely to have an adverse conception outcome (odds ratio, 1.65; 95% confidence interval, 1.09–2.48), an adverse pregnancy outcome (odds ratio, 1.54; 95% confidence interval, 1.00–2.38), or a pregnancy complication (odds ratio, 1.78; 95% confidence interval, 1.13–2.81); however, the difference between the 2 groups in adverse newborn outcomes was not statistically significant (odds ratio, 1.89; 95% confidence interval, 0.98–3.69). Independent predictors of an adverse outcome included a diagnosis of IBD, a history of surgery for IBD, and non-Caucasian ethnicity. Severity of disease and medical treatments were not associated with an adverse outcome.

Conclusions: Women with IBD are more likely to have an adverse outcome related to pregnancy. Disease activity and medical treatment did not predict adverse outcomes in a large, nonreferral population.

Supported by the Crohn’s Colitis Foundation of America First Award and supplemental funding, the Foundation for Clinical Research in IBD, the Schoenberg Foundation, the Permanente Medical Group, and the National Institutes of Health (K08 DK002697-05).Address requests for reprints to: Uma Mahadevan, MD, Associate Professor of Medicine, Center for Colitis and Crohn’s Disease, University of California San Francisco, 2330 Post Street #610, San Francisco, California 94115. fax: .

Gastroenterology Volume 133, Issue 4, October 2007, Pages 1106-1112