Adverse obstetric outcome risk with IBD ‘moderately low’
MedWire News: A reassuring study suggests the most women with inflammatory bowel disease (IBD) will have a pregnancy that proceeds normally, although there is an increased risk of the child being born small for gestational age.
Finnish researchers report that the overall risk of an adverse obstetric outcome was 'moderately low' for women with IBD, although they were twice as likely as others to give birth to a child that was small for gestational age.
The team says: "Our results showed that the effect on fetal growth was clearly associated with the onset of the disease, as there was no risk of impaired fetal growth in women who were diagnosed with IBD after pregnancy."
Kaisa Raatikainen (Kuopio University Hospital) and colleagues conducted a retrospective analysis of 212 women who were diagnosed or treated at Kuopio University hospital for IBD and who gave birth between 1989 and 2006.
These women were compared with the entire obstetric population of the hospital, which acted as a reference group.
IBD was present in 0.35% of pregnancies progressing beyond 22 weeks, which equated to one in every 284 pregnancies.
Pregnancies in women with IBD proceeded normally with respect to most factors, although they had significantly lower mean hemoglobin concentrations and maternal weight gain.
Women with IBD were not at increased risk of preterm birth or the need for neonatal intensive care. But they had more than double the risk of bearing a child small for gestational age or undergoing Cesarean section compared with other women, with adjusted odds ratios of 2.08 and 2.75, respectively.
Reporting in the journal Alimentary Pharmacology and Therapeutics, the researchers note that normal maternal weight gain, possibly indicating a more stable disease, appeared to protect against adverse outcomes.
They conclude: "The commonly held fears about childbirth recently reported among IBD patients are not justifiable on the basis of the results of the current study.
"However, pregnancies in women with IBD should be considered associated with a low-to-moderate risk, depending on the activity of the disease. Therefore, monitoring at specialized maternity clinics appears to be advisable, aiming at early recognition and adequate treatment of growth-restricted fetuses."
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By Anita Wilkinson