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Elevated interferon-gamma levels during pregnancy are associated with adverse maternofetal outcomes in IBD
  1. Humberto Jijon1,
  2. Aito Ueno1,
  3. Nastaran Sharifi1,
  4. Yvette Leung2,
  5. Subrata Ghosh3,
  6. Cynthia Seow1
  1. 1Department of Medicine, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
  2. 2Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
  3. 3Institute of Translational Medicine, University of Birmingham Edgbaston Campus, Birmingham, UK
  1. Correspondence to Dr Cynthia Seow, Department of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada; cseow{at}ucalgary.ca

https://doi.org/10.1136/gutjnl-2019-319656

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    We read with interest van der Giessen’s observations of pregnancy-associated fluctuations in peripheral blood cytokines and stool microbiota in the setting of IBD.1 In this study, the authors profiled preconception and pregnancy-associated cytokine levels and demonstrated a significant decrease in proinflammatory cytokines (interleukin (IL)-6, IL-8, IL-12, IL-17 and tumour necrosis factor-α) during pregnancy in women with IBD.

    We had undertaken a similar cytokine analysis of pregnant women with IBD at the University of Calgary but sought to relate preconception and second-trimester cytokine levels with adverse maternal–fetal outcomes, including preterm birth, emergency caesarean delivery and neonatal intensive care unit (NICU) admission. Sera from 28 women with IBD, including 19 with Crohn’s disease (CD) and 9 with UC who completed a pregnancy between 2013 and 2015, were analysed. Eighteen of these patients were on biological therapy preconception (infliximab n (CD)=7, n (UC)=4; adalimumab n (CD)=7). Disease activity was prospectively evaluated using validated disease activity indices, physician global assessment and C-reactive protein. Faecal calprotectin results were not available. Only one patient (with CD) had active disease at the time of preconception blood sampling, while three women (1 with …

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    Footnotes

    • Contributors HJ, AU, NS, YL, SG and CS contributed to the study design, data collection, data analysis, manuscript drafting and editing.

    • Funding This study was funded by Alberta Innovates Health Solutions.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.