Crohn’s disease (CD) and ulcerative colitis (UC) often affect women of childbearing age. A new population-based study published in Alimentary Pharmacology & Therapeutics looked at the outcomes for pregnant women with inflammatory bowel disease (IBD) compared the health of pregnant and non-pregnant women with CD or UC in South Korea.

This large cohort study included 2,058 women with IBD, who became pregnant over a 10-year period from 2007, plus 20,580 women of similar age who did not have IBD as controls.

 

Figure 1. Pregnant IBD patients could benefit from tighter disease control Photo created by freepik – www.freepik.com

Women with IBD overall did well during pregnancy; but rates of Caesarean section and intrauterine growth retardation (low birth weight babies) were higher than in women without IBD. Of the patients with Crohn’s disease (CD), those with quiescent-to-mild CD had similar outcomes to women without IBD; however, women with moderate to severe CD had a higher rate of miscarriage and almost a 3-fold higher rate of intrauterine growth retardation than women without IBD.

Previous studies could be easily biased since considerable numbers of pregnant women with IBD with quiescent or mild activity were likely to be excluded. We overcame this limitation by using a nationwide database covering 98% of the 52 million citizens of an entire nation” said corresponding author Bo-In Lee, MD, PhD, of The Catholic University of Korea.

Could better Prognosis help pregnant IBD patients?

The authors conclude that “because the risks of adverse pregnancy outcomes are increased in patients with moderate to severe disease, women with IBD who are preparing for pregnancy should be treated more intensively by physicians to reach a remission stage in the disease.”

PredictSURE IBD, the first fully validated prognostic test for IBD, stratifies patients based on their risk of frequently relapsing disease. Having identified patients at high risk of an active disease course, clinicians have a “window of opportunity” to achieve remission by treating high risk patients using more aggressive therapies such as biologics. Approaching therapy in this way can block disease progression and establish deep remission.

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