title: Complications from inflammatory bowel disease during pregnancy and delivery.
abstract: OBJECTIVE
  Little is known about complications from ulcerative colitis (UC) or Crohn's disease (CD) during pregnancy and delivery. We assessed complications by using data from a large, population-based cohort.
  
  
  METHODS
  We analyzed data from 1209 women with UC, 787 women with CD, and 10,773 women without these diseases (the comparison group) by using the Medical Birth, Patient, and Prescribed Drug Registers of all residents in Sweden. All the women included in the analysis gave birth to a single infant between October 2006 and December 2009. We used data on medical treatment, surgery, and hospital admissions to assess disease activity. Risks of pregnancy and delivery complications were determined from adjusted odds ratios (aORs) with 95% confidence intervals (CIs).
  
  
  RESULTS
  The risk of venous thromboembolism was increased among women with UC (aOR, 3.78; 95% CI, 1.52-9.38), particularly for those with flaring disease. Women with CD had a higher risk of antepartum hemorrhage (aOR, 1.66; 95% CI, 1.12-2.45), with the highest risks among those with no disease activity. Risks of elective cesarean delivery were more than doubled among women with UC (aOR, 2.44; 95% CI, 2.06-2.88) or CD (aOR, 2.31; 95% CI, 1.89-2.83). Women with UC (aOR, 1.39; 95% CI, 1.13-1.70) or CD (aOR, 1.50; 95% CI, 1.17-1.92) had increased risk for emergency cesarean delivery. Women with an inactive UC or flaring CD had the highest risks of cesarean delivery.
  
  
  CONCLUSIONS
  Women with UC or CD have more complications during pregnancy and delivery than women without these diseases. Disease activity affects mode of delivery, and thrombophilic events present differently in women with UC vs CD.
authors.affiliation: Centre for Pharmacoepidemiology/Unit of Clinical Epidemiology, Karolinska Institutet, Stockholm, Sweden. gabriella.broms@ki.se
authors.forename: Gabriella
authors.initials: G
authors.lastname: Bröms
authors.forename: Fredrik
authors.initials: F
authors.lastname: Granath
authors.forename: Marie
authors.initials: M
authors.lastname: Linder
authors.forename: Olof
authors.initials: O
authors.lastname: Stephansson
authors.forename: Maria
authors.initials: M
authors.lastname: Elmberg
authors.forename: Helle
authors.initials: H
authors.lastname: Kieler
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000706:statistics & numerical data; D003093:Colitis, Ulcerative / Q000150:complications* / Q000473:pathology*; D003424:Crohn Disease / Q000150:complications* / Q000473:pathology*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D015995:Prevalence; D013548:Sweden; D014592:Uterine Hemorrhage / Q000453:epidemiology; D054556:Venous Thromboembolism / Q000453:epidemiology; D055815:Young Adult