Cargando…

Predictors of Cesarean Delivery in Pregnant Women with Inflammatory Bowel Disease

AIM: Pregnant women with Crohn’s disease (CD) or ulcerative colitis (UC) are likelier to undergo Cesarean delivery than women without IBD. Active perianal disease is the only IBD-related indication for Cesarean delivery. We sought to identify clinical factors contributing to these high rates. METHOD...

Descripción completa

Detalles Bibliográficos
Autores principales: Sharaf, Amy A, Nguyen, Geoffrey C
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6488002/
https://www.ncbi.nlm.nih.gov/pubmed/31294403
http://dx.doi.org/10.1093/jcag/gwy003
_version_ 1783414583757635584
author Sharaf, Amy A
Nguyen, Geoffrey C
author_facet Sharaf, Amy A
Nguyen, Geoffrey C
author_sort Sharaf, Amy A
collection PubMed
description AIM: Pregnant women with Crohn’s disease (CD) or ulcerative colitis (UC) are likelier to undergo Cesarean delivery than women without IBD. Active perianal disease is the only IBD-related indication for Cesarean delivery. We sought to identify clinical factors contributing to these high rates. METHODS: We conducted a retrospective cohort study of 369 pregnant women with IBD who delivered at our institution between 2006 and 2014. We used logistic regression to identify clinical predictors of Cesarean delivery. RESULTS: The Cesarean delivery rate among women with CD and UC were 52% and 48%, respectively. Thirty of Cesarean deliveries (54%) in CD and UC patients were performed emergently, respectively. Among those with CD, the strongest predictors of Cesarean delivery were history of perianal disease (adjusted odds ratio [aOR), 13.6; 95% CI: 3.87–47.5) and prior Cesarean delivery (aOR, 22.2; 95% CI: 6.16–80.2). Among women who underwent Cesarean delivery because of perianal disease, only 42% had active perianal symptoms during pregnancy. In UC patients, history of colectomy was a predictor of Cesarean delivery (aOR, 5.08; 95% CI: 1.95–13.2). Cesarean delivery increased the postpartum length of stay by 1.1 days on average for both CD and UC patients, reflecting a 57% and 90% increase over vaginal delivery after adjusting for confounders. CONCLUSIONS: The decision to perform Cesarean delivery for women with IBD is complex involving IBD-related and obstetric factors and is ideally made by a multidisciplinary team that includes input from a gastroenterologist and obstetrician.
format Online
Article
Text
id pubmed-6488002
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher Oxford University Press
record_format MEDLINE/PubMed
spelling pubmed-64880022019-07-10 Predictors of Cesarean Delivery in Pregnant Women with Inflammatory Bowel Disease Sharaf, Amy A Nguyen, Geoffrey C J Can Assoc Gastroenterol Original Articles AIM: Pregnant women with Crohn’s disease (CD) or ulcerative colitis (UC) are likelier to undergo Cesarean delivery than women without IBD. Active perianal disease is the only IBD-related indication for Cesarean delivery. We sought to identify clinical factors contributing to these high rates. METHODS: We conducted a retrospective cohort study of 369 pregnant women with IBD who delivered at our institution between 2006 and 2014. We used logistic regression to identify clinical predictors of Cesarean delivery. RESULTS: The Cesarean delivery rate among women with CD and UC were 52% and 48%, respectively. Thirty of Cesarean deliveries (54%) in CD and UC patients were performed emergently, respectively. Among those with CD, the strongest predictors of Cesarean delivery were history of perianal disease (adjusted odds ratio [aOR), 13.6; 95% CI: 3.87–47.5) and prior Cesarean delivery (aOR, 22.2; 95% CI: 6.16–80.2). Among women who underwent Cesarean delivery because of perianal disease, only 42% had active perianal symptoms during pregnancy. In UC patients, history of colectomy was a predictor of Cesarean delivery (aOR, 5.08; 95% CI: 1.95–13.2). Cesarean delivery increased the postpartum length of stay by 1.1 days on average for both CD and UC patients, reflecting a 57% and 90% increase over vaginal delivery after adjusting for confounders. CONCLUSIONS: The decision to perform Cesarean delivery for women with IBD is complex involving IBD-related and obstetric factors and is ideally made by a multidisciplinary team that includes input from a gastroenterologist and obstetrician. Oxford University Press 2018-04-02 /pmc/articles/PMC6488002/ /pubmed/31294403 http://dx.doi.org/10.1093/jcag/gwy003 Text en © The Author(s) 2018. Published by Oxford University Press on behalf of the Canadian Association of Gastroenterology. http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Original Articles
Sharaf, Amy A
Nguyen, Geoffrey C
Predictors of Cesarean Delivery in Pregnant Women with Inflammatory Bowel Disease
title Predictors of Cesarean Delivery in Pregnant Women with Inflammatory Bowel Disease
title_full Predictors of Cesarean Delivery in Pregnant Women with Inflammatory Bowel Disease
title_fullStr Predictors of Cesarean Delivery in Pregnant Women with Inflammatory Bowel Disease
title_full_unstemmed Predictors of Cesarean Delivery in Pregnant Women with Inflammatory Bowel Disease
title_short Predictors of Cesarean Delivery in Pregnant Women with Inflammatory Bowel Disease
title_sort predictors of cesarean delivery in pregnant women with inflammatory bowel disease
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6488002/
https://www.ncbi.nlm.nih.gov/pubmed/31294403
http://dx.doi.org/10.1093/jcag/gwy003
work_keys_str_mv AT sharafamya predictorsofcesareandeliveryinpregnantwomenwithinflammatoryboweldisease
AT nguyengeoffreyc predictorsofcesareandeliveryinpregnantwomenwithinflammatoryboweldisease