title: Intrapartum corticosteroid use significantly increases the risk of gestational diabetes in women with inflammatory bowel disease.
abstract: OBJECTIVE
  Women with inflammatory bowel disease (IBD) may be at higher risk of adverse pregnancy outcomes. This study compared perinatal outcomes in women with and without IBD.
  
  
  METHODS
  The population-based Data Integration, Measurement, and Reporting (DIMR) administrative discharge database was used to identify women (≥18 years of age) in Alberta, Canada, with IBD who delivered a baby between 2006 and 2009 inclusive. Women without IBD were randomly sampled and matched in a 3:1 ratio to IBD cases by age at conception (±1 year). Odds ratios of gestational diabetes, preterm birth, low birth weight, cesarean section, and neonatal intensive care unit admission were calculated.
  
  
  RESULTS
  One hundred and sixteen IBD patients were age-matched to 381 pregnant women without IBD. Gestational diabetes, preterm birth, and cesarean section were more common in women with IBD compared with controls (6.9 versus 1.8%, p = 0.03; 12.9 versus 0.3%, p < 0.0001; 43.1 versus 21.0%, p = 0.009, respectively). On multivariate analysis, women with IBD were independently more likely to have gestational diabetes (odds ratio [OR] = 4.3; 95% confidence interval [CI] 1.2-16.3), preterm birth (OR = 19.7, 95% CI 2.2-173.9), and to deliver by cesarean section (OR = 2.7, 95% CI 1.6-4.6) after adjusting for age and smoking status.
  
  
  CONCLUSIONS
  Intrapartum corticosteroid use significantly increases the risk of gestational diabetes in women with IBD. Furthermore, IBD patients are at higher risk of preterm delivery and are more likely to undergo cesarean section compared with a healthy age-matched population. The finding of a higher risk of gestational diabetes is a novel finding not previously reported in the IBD literature.
authors.affiliation: Department of Medicine, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Yvette P Y
authors.initials: YP
authors.lastname: Leung
authors.affiliation: Department of Medicine, University of Calgary, Calgary, Alberta, Canada Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Gilaad G
authors.initials: GG
authors.lastname: Kaplan
authors.affiliation: Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Coward
authors.affiliation: Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Divine
authors.initials: D
authors.lastname: Tanyingoh
authors.affiliation: Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada Department of Paediatrics, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Bonnie J
authors.initials: BJ
authors.lastname: Kaplan
authors.affiliation: Department of Paediatrics, University of Calgary, Calgary, Alberta, Canada.
authors.forename: David W
authors.initials: DW
authors.lastname: Johnston
authors.affiliation: Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada Department of Production Animal Health, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Herman W
authors.initials: HW
authors.lastname: Barkema
authors.affiliation: Department of Medicine, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Subrata
authors.initials: S
authors.lastname: Ghosh
authors.affiliation: Department of Medicine, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Remo
authors.initials: R
authors.lastname: Panaccione
authors.affiliation: Department of Medicine, University of Calgary, Calgary, Alberta, Canada Department of Production Animal Health, University of Calgary, Calgary, Alberta, Canada cseow@ucalgary.ca.
authors.forename: Cynthia H
authors.initials: CH
authors.lastname: Seow
mesh_terms: D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000009:adverse effects* / Q000627:therapeutic use; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000009:adverse effects* / Q000627:therapeutic use; D016022:Case-Control Studies; D002585:Cesarean Section / Q000706:statistics & numerical data; D016640:Diabetes, Gestational / Q000139:chemically induced*; D005260:Female; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy*; D015931:Intensive Care, Neonatal / Q000706:statistics & numerical data; D016015:Logistic Models; D016555:Matched-Pair Analysis; D015999:Multivariate Analysis; D016017:Odds Ratio; D011247:Pregnancy; D011248:Pregnancy Complications / Q000139:chemically induced / Q000188:drug therapy; D011256:Pregnancy Outcome; D047928:Premature Birth / Q000139:chemically induced; D012307:Risk Factors; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones; D000893:Anti-Inflammatory Agents
keywords: Crohn’s disease; Pregnancy; gestational diabetes; preterm birth; ulcerative colitis