title: Association between maternal inflammatory bowel disease and adverse perinatal outcomes.
abstract: OBJECTIVE
  To examine whether inflammatory bowel disease (IBD) is associated with ischemic/inflammatory conditions during pregnancy.
  
  
  METHODS
  A retrospective cohort study using the 2000 to 2012 Kaiser Permanente Southern California maternally-linked medical records (n=395 781). The two major subtypes of IBD, ulcerative colitis and Crohn's diseases were studied. Adjusted odds ratios (ORs) were used to quantify the associations.
  
  
  RESULTS
  A pregnancy complicated by IBD was associated with increased incidence of small-for-gestational age birth (OR=1.46, 95% confidence interval (CI)=1.14 to 1.88), spontaneous preterm birth (OR=1.32, 95% CI=1.00 to 1.76) and preterm premature rupture of membranes (OR=1.95, 95% CI=1.26 to 3.02). Further stratifying by IBD subtypes, only ulcerative colitis was significantly associated with increased incidence of ischemic placental disease, spontaneous preterm birth and preterm premature rupture of membranes.
  
  
  CONCLUSIONS
  The findings underscore the potential impact of maternal IBD on adverse perinatal outcomes. Clinicians should be aware that the association between IBD and adverse perinatal outcome varies by IBD subtypes.
authors.affiliation: 1] Department of Research & Evaluation, Kaiser Permanente Southern California Medical Group, Pasadena, CA, USA [2] Department of Obstetrics and Gynecology, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
authors.forename: D
authors.initials: D
authors.lastname: Getahun
authors.affiliation: Department of Maternal-Fetal Medicine, West Los Angeles Medical Center, Kaiser Permanente Southern California Medical Group, Pasadena, CA, USA.
authors.forename: M J
authors.initials: MJ
authors.lastname: Fassett
authors.affiliation: Department of Research & Evaluation, Kaiser Permanente Southern California Medical Group, Pasadena, CA, USA.
authors.forename: G F
authors.initials: GF
authors.lastname: Longstreth
authors.affiliation: Department of Research & Evaluation, Kaiser Permanente Southern California Medical Group, Pasadena, CA, USA.
authors.forename: C
authors.initials: C
authors.lastname: Koebnick
authors.affiliation: Department of Research & Evaluation, Kaiser Permanente Southern California Medical Group, Pasadena, CA, USA.
authors.forename: A M
authors.initials: AM
authors.lastname: Langer-Gould
authors.affiliation: Department of Research & Evaluation, Kaiser Permanente Southern California Medical Group, Pasadena, CA, USA.
authors.forename: D
authors.initials: D
authors.lastname: Strickland
authors.affiliation: Department of Research & Evaluation, Kaiser Permanente Southern California Medical Group, Pasadena, CA, USA.
authors.forename: S J
authors.initials: SJ
authors.lastname: Jacobsen
mesh_terms: D000328:Adult; D002140:California / Q000453:epidemiology; D015331:Cohort Studies; D003093:Colitis, Ulcerative / Q000150:complications*; D003424:Crohn Disease / Q000150:complications*; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000209:etiology; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D009035:Mothers; D011247:Pregnancy; D011248:Pregnancy Complications; D011256:Pregnancy Outcome; D047928:Premature Birth / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult