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Risk of Adverse Pregnancy Outcomes for Women with IBD in an Expert IBD Antenatal Clinic

Background: Patients with inflammatory bowel disease (IBD) are at increased risk of adverse outcomes from pregnancy. It is unclear whether IBD indications account for the higher rate of Caesarean section (CS) in IBD patients. Methods: A retrospective cohort study of 179 IBD patients cared for in a d...

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Autores principales: Lever, Gillian, Chipeta, Hlupekile, Glanville, Tracey, Selinger, Christian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9146846/
https://www.ncbi.nlm.nih.gov/pubmed/35629046
http://dx.doi.org/10.3390/jcm11102919
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author Lever, Gillian
Chipeta, Hlupekile
Glanville, Tracey
Selinger, Christian
author_facet Lever, Gillian
Chipeta, Hlupekile
Glanville, Tracey
Selinger, Christian
author_sort Lever, Gillian
collection PubMed
description Background: Patients with inflammatory bowel disease (IBD) are at increased risk of adverse outcomes from pregnancy. It is unclear whether IBD indications account for the higher rate of Caesarean section (CS) in IBD patients. Methods: A retrospective cohort study of 179 IBD patients cared for in a dedicated combined IBD antenatal clinic and 31,528 non-IBD patients was performed. The outcomes were method of delivery, preterm birth, birthweight, admission to neonatal intensive care unit (NICU), and stillbirth. We analysed the associations between disease activity, medication with method of delivery, and neonatal outcomes. Results: Delivery by CS was more common in IBD patients (RR 1.45, CI 1.16–1.81, p = 0.0021); emergency CS delivery was equally likely (RR 1.26, CI 0.78–2.07, p = 0.3). Forty percent of elective CS were performed for IBD indications. Stillbirth was five-fold higher in IBD patients (RR 5.14, CI 1.92–13.75, p < 0.001). Preterm delivery, low birthweight, and admission to NICU were not more common in patients with IBD, and IBD medications did not increase these risks. Active disease during pregnancy was not associated with adverse outcomes. Conclusions: Delivery by CS was more frequent in the IBD cohort, and most elective CSs were obstetrically indicated. A dedicated IBD antenatal clinic providing closer monitoring and early detection of potential issues may help improve outcomes.
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spelling pubmed-91468462022-05-29 Risk of Adverse Pregnancy Outcomes for Women with IBD in an Expert IBD Antenatal Clinic Lever, Gillian Chipeta, Hlupekile Glanville, Tracey Selinger, Christian J Clin Med Article Background: Patients with inflammatory bowel disease (IBD) are at increased risk of adverse outcomes from pregnancy. It is unclear whether IBD indications account for the higher rate of Caesarean section (CS) in IBD patients. Methods: A retrospective cohort study of 179 IBD patients cared for in a dedicated combined IBD antenatal clinic and 31,528 non-IBD patients was performed. The outcomes were method of delivery, preterm birth, birthweight, admission to neonatal intensive care unit (NICU), and stillbirth. We analysed the associations between disease activity, medication with method of delivery, and neonatal outcomes. Results: Delivery by CS was more common in IBD patients (RR 1.45, CI 1.16–1.81, p = 0.0021); emergency CS delivery was equally likely (RR 1.26, CI 0.78–2.07, p = 0.3). Forty percent of elective CS were performed for IBD indications. Stillbirth was five-fold higher in IBD patients (RR 5.14, CI 1.92–13.75, p < 0.001). Preterm delivery, low birthweight, and admission to NICU were not more common in patients with IBD, and IBD medications did not increase these risks. Active disease during pregnancy was not associated with adverse outcomes. Conclusions: Delivery by CS was more frequent in the IBD cohort, and most elective CSs were obstetrically indicated. A dedicated IBD antenatal clinic providing closer monitoring and early detection of potential issues may help improve outcomes. MDPI 2022-05-22 /pmc/articles/PMC9146846/ /pubmed/35629046 http://dx.doi.org/10.3390/jcm11102919 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Lever, Gillian
Chipeta, Hlupekile
Glanville, Tracey
Selinger, Christian
Risk of Adverse Pregnancy Outcomes for Women with IBD in an Expert IBD Antenatal Clinic
title Risk of Adverse Pregnancy Outcomes for Women with IBD in an Expert IBD Antenatal Clinic
title_full Risk of Adverse Pregnancy Outcomes for Women with IBD in an Expert IBD Antenatal Clinic
title_fullStr Risk of Adverse Pregnancy Outcomes for Women with IBD in an Expert IBD Antenatal Clinic
title_full_unstemmed Risk of Adverse Pregnancy Outcomes for Women with IBD in an Expert IBD Antenatal Clinic
title_short Risk of Adverse Pregnancy Outcomes for Women with IBD in an Expert IBD Antenatal Clinic
title_sort risk of adverse pregnancy outcomes for women with ibd in an expert ibd antenatal clinic
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9146846/
https://www.ncbi.nlm.nih.gov/pubmed/35629046
http://dx.doi.org/10.3390/jcm11102919
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