Clinical–alimentary tractPregnancy Outcomes in Women With Inflammatory Bowel Disease: A Large Community-Based Study From Northern California
Section snippets
Study Design
We performed a cohort study of all pregnant women with IBD and a random selection of pregnant women without IBD who were frequency-matched by age at pregnancy and geographic center. The institutional review boards of the University of California San Francisco and the Kaiser Foundation Research Institute approved this study.
Study Population
The underlying study population included all members of the Kaiser Permanente integrated health care delivery system between the years 1995 and 2002. The total membership
Overview
A total of 493 pregnant women with IBD (exposed) were matched to pregnant women without IBD (unexposed). Thirty-two initially selected subjects were excluded because the medical record review failed to confirm either IBD or a pregnancy.
Because of matching on age, the mean age at conception was 30 years of age for both groups. There were 300 patients with UC and 154 patients with CD. Very few patients were exposed to biologics or immunosuppressants during pregnancy and conception (4%), whereas
Discussion
Women with IBD are less likely to have a live birth and more likely to have an adverse outcome related to gestation than women without IBD. In particular, adverse conception outcomes (spontaneous or abortion unknown) and pregnancy complications were more likely in women with IBD. However, we did not observe a statistically significant difference in newborn outcomes between the 2 groups. Having IBD, and a history of surgery for IBD, were strong predictors of an adverse outcome when compared with
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Supported by the Crohn’s Colitis Foundation of America First Award and supplemental funding, the Foundation for Clinical Research in IBD, the Schoenberg Foundation, the Permanente Medical Group, and the National Institutes of Health (K08 DK002697-05).