title: Inflammatory bowel disease in pregnancy: a population-based study of prevalence and pregnancy outcomes.
abstract: OBJECTIVE
  To determine the prevalence of the inflammatory bowel diseases (IBD), ulcerative colitis (UC) and Crohn's disease (CD), in pregnant women and determine pregnancy and fetal/neonatal outcomes.
  
  
  METHODS
  Population-based cohort study.
  
  
  METHODS
  New South Wales, Australia, 2001-11.
  
  
  METHODS
  A total of 630 742 women who delivered at ≥20 weeks of gestation.
  
  
  METHODS
  Descriptive and multivariate regression analyses of perinatal data linked to hospital admission data. We compared birth outcomes of women with and without a documented diagnosis of IBD.
  
  
  METHODS
  Caesarean section, severe maternal morbidity, preterm birth <37 weeks of gestation, planned preterm birth, small-for-gestational-age (birthweight <10th centile), perinatal mortality (stillbirth/neonatal death ≤28 days).
  
  
  RESULTS
  In all, 1960 women (0.31%) with IBD, who had 2781 births (1183 UC, 1287 CD and 311 IBD-indeterminate). Women with IBD were more likely than women without IBD to have a caesarean section [41.5 versus 28.2%, adjusted risk ratio (aRR) 1.38, 95% CI 1.31-1.45], severe maternal morbidity (2.6 versus 1.6%, aRR 1.54, 95% CI 1.17-2.03), preterm birth (9.7 versus 6.6%, aRR 1.47, 95% CI 1.30-1.66), planned preterm birth (5.3 versus 2.9%, aRR 1.74, 95% CI 1.47-2.07), and their infants to be small-for-gestational-age (9.7 versus 9.5%, aRR 1.19, 95% CI 1.04-1.36). There was no evidence of a difference in perinatal mortality.
  
  
  CONCLUSIONS
  Pregnancy-associated IBD is more common than previously reported. Pregnancies complicated by IBD at or near the time of birth have significantly higher rates of adverse pregnancy outcomes than pregnancies of women without IBD.
  
  
  CONCLUSIONS
  Increased rates preterm birth and caesarean section in women with inflammatory bowel disease.
authors.affiliation: Clinical and Population Perinatal Health Research, Kolling Institute, University of Sydney, Sydney, NSW, Australia. Antonia.shand@sydney.edu.au.|Department of Maternal Fetal Medicine, Royal Hospital for Women, Randwick, NSW, Australia. Antonia.shand@sydney.edu.au.
authors.forename: A W
authors.initials: AW
authors.lastname: Shand
authors.affiliation: Clinical and Population Perinatal Health Research, Kolling Institute, University of Sydney, Sydney, NSW, Australia.
authors.forename: J S
authors.initials: JS
authors.lastname: Chen
authors.affiliation: AW Morrow Gastroenterology and Liver Centre, Royal Prince Alfred Hospital, Camperdown, NSW, Australia.|Faculty of Medicine, Central Clinical School, University of Sydney, Sydney, NSW, Australia.
authors.forename: W
authors.initials: W
authors.lastname: Selby
authors.affiliation: SOuRCe (Surgical Outcomes Research Centre), The Institute of Academic Surgery, Royal Prince Alfred Hospital, University of Sydney, Camperdown, Sydney, NSW, Australia.
authors.forename: M
authors.initials: M
authors.lastname: Solomon
authors.affiliation: Clinical and Population Perinatal Health Research, Kolling Institute, University of Sydney, Sydney, NSW, Australia.
authors.forename: C L
authors.initials: CL
authors.lastname: Roberts
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000706:statistics & numerical data; D003093:Colitis, Ulcerative / Q000453:epidemiology*; D003424:Crohn Disease / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D009517:New South Wales / Q000453:epidemiology; D054238:Perinatal Mortality; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011256:Pregnancy Outcome; D047928:Premature Birth / Q000453:epidemiology; D015995:Prevalence
keywords: Crohn's disease; inflammatory bowel disease; population-based; pregnancy; ulcerative colitis