Pregnancy and inflammatory bowel disease: a prospective case-control study.
OBJECTIVE
Taking into account the relative confusion in the literature concerning the influence of pregnancy on the underlying inflammatory bowel disease (IBD) and vice versa, as well as the influence of drugs on the foetus and the gestation itself, we performed this prospective study, in order to further elucidate this interesting topic.


METHODS
Prospective follow-up study of 9 pregnant women with previously established IBD, 4 with ulcerative colitis (UC) and 5 with Crohn's disease (CD). Results were compared to those of 9 non-pregnant women with IBD with similar clinico-demographic characteristics (disease control group), and 18 healthy pregnancy women (healthy control group).


RESULTS
(a) Patients with IBD and gestation vs. healthy control group: Significantly impaired body weight in newborns from IBD mothers compared to healthy women (2530 +/- 961 g vs. 3242 +/- 582 g, P = 0.035) was found. Significantly more cases of therapeutic or spontaneous abortion and premature delivery in pregnant women with IBD compared to healthy pregnant women [5/ 9(56.6%) vs 1/18 (5.6%), P = 0.008] were also noticed. Concerning drug consumption, it was noticed that azathioprine was taken regularly in one case of spontaneous abortion and in one case of premature delivery. No significant differences concerning other parameters such as smoking habit and death of foetus were observed. (b) Patients with IBD and gestation vs. patients with IBD without gestation: No significant differences in the history of various parameters of the disease (number of operations, presence of fistulas), previous gestations, and course of the disease during the period of gestation were found. (c) Course of the disease six months after delivery: No significant differences between patients with IBD and pregnancy and disease control group were noticed.


CONCLUSIONS
It is concluded that gestation in women with IBD is accompanied by some unwanted events such as premature delivery, therapeutic or spontaneous abortion, and reduced newborn body weight. Clinicians must bear in mind the possibility of the appearance of some unwanted events in pregnant women with IBD during their gestation.
Malgarinos
G
G
Saint Panteleimon General State Hospital Nikea, Department of Gastroenterology.
Gikas
A
A
Delicha
Evi
E
Stamataki
Asteria
A
Georgopoulos
F
F
Papadimitriou
A
A
Stanciu
C
C
Triantafillidis
J K
JK
D000022:Abortion, Spontaneous / Q000139:chemically induced / Q000209:etiology*; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000009:adverse effects; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000627:therapeutic use; D001379:Azathioprine / Q000009:adverse effects; D016022:Case-Control Studies; D003093:Colitis, Ulcerative / Q000150:complications; D003424:Crohn Disease / Q000150:complications; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006115:Greece; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D015212:Inflammatory Bowel Diseases / Q000150:complications* / Q000188:drug therapy; D000069285:Infliximab; D019804:Mesalamine / Q000009:adverse effects; D011247:Pregnancy; D011248:Pregnancy Complications; D011256:Pregnancy Outcome; D047928:Premature Birth / Q000209:etiology*; D011446:Prospective Studies
D000893:Anti-Inflammatory Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000911:Antibodies, Monoclonal; D007166:Immunosuppressive Agents; D019804:Mesalamine; D000069285:Infliximab; D001379:Azathioprine