title: Does pregnancy change the disease course? A study in a European cohort of patients with inflammatory bowel disease.
abstract: OBJECTIVE
  Inflammatory bowel disease (IBD) often affects patients in their fertile age. The aim of this study was to describe pregnancy outcome in a European cohort of IBD patients. As data are limited regarding the effect of pregnancy on disease course, our second objective was to investigate whether pregnancy influences disease course and phenotype in IBD patients.
  
  
  METHODS
  In a European cohort of IBD patients, a 10-yr follow-up was performed by scrutinizing patient files and approaching the patients with a questionnaire. The cohort comprised 1,125 patients, of whom 543 were women. Data from 173 female ulcerative colitis (UC) and 93 Crohn's disease (CD) patients form the basis for the present study.
  
  
  RESULTS
  In all, 580 pregnancies, 403 occurring before and 177 after IBD was diagnosed, were reported. The rate of spontaneous abortion increased after IBD was diagnosed (6.5% vs. 13%, p = 0.005), whereas elective abortion was not significantly different. 48.6% of the patients took medication at the time of conception and 46.9% during pregnancy. The use of cesarean section increased after IBD diagnosis (8.1% vs 28.7% of pregnancies). CD patients pregnant during the disease course, did not differ from patients who were not pregnant during the disease course regarding the development of stenosis (37% vs 52% p = 0.13) and resection rates (mean number of resections 0.52 vs 0.66, p = 0.37). The rate of relapse decreased in the years following pregnancy in both UC (0.34 vs 0.18 flares/yr, p = 0.008) and CD patients (0.76 vs 0.12 flares/yr, p = 0.004).
  
  
  CONCLUSIONS
  Pregnancy did not influence disease phenotype or surgery rates, but was associated with a reduced number of flares in the following years.
authors.affiliation: Department of Medical Gastroenterology, Herlev Hospital, University of Copenhagen, Herlev, Denmark.
authors.forename: Lene
authors.initials: L
authors.lastname: Riis
authors.forename: Ida
authors.initials: I
authors.lastname: Vind
authors.forename: Patrizia
authors.initials: P
authors.lastname: Politi
authors.forename: Frank
authors.initials: F
authors.lastname: Wolters
authors.forename: Severine
authors.initials: S
authors.lastname: Vermeire
authors.forename: Epameinondas
authors.initials: E
authors.lastname: Tsianos
authors.forename: João
authors.initials: J
authors.lastname: Freitas
authors.forename: Ioannis
authors.initials: I
authors.lastname: Mouzas
authors.forename: Victor
authors.initials: V
authors.lastname: Ruiz Ochoa
authors.forename: Colm
authors.initials: C
authors.lastname: O'Morain
authors.forename: Selwyn
authors.initials: S
authors.lastname: Odes
authors.forename: Vibeke
authors.initials: V
authors.lastname: Binder
authors.forename: Bjørn
authors.initials: B
authors.lastname: Moum
authors.forename: Reinhold
authors.initials: R
authors.lastname: Stockbrügger
authors.forename: Ebbe
authors.initials: E
authors.lastname: Langholz
authors.forename: Pia
authors.initials: P
authors.lastname: Munkholm
mesh_terms: D000328:Adult; D016009:Chi-Square Distribution; D015331:Cohort Studies; D018450:Disease Progression; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000453:epidemiology / Q000473:pathology*; D010641:Phenotype; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000473:pathology*; D011256:Pregnancy Outcome; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires