IBD May Increase Risk for Adverse Pregnancy Outcomes

Women with inflammatory bowel disease (IBD) more often have gestational diabetes and preterm premature rupture of membranes, according to a review published online January in Alimentary Pharmacology and Therapeutics.

Parul Tandon, D.O., from the University of Toronto, and colleagues conducted a systematic review to examine the risk for adverse maternal, placental, and obstetric outcomes in women with IBD versus healthy controls. Data were included from 53 studies with 7,917 IBD pregnancies and 3,253 healthy control pregnancies.

The researchers found that compared with healthy controls, cesarean delivery was more common in patients with IBD (odds ratio [OR], 1.79; 95 percent confidence interval [CI], 1.16 to 2.77). This association remained significant for ulcerative colitis (OR, 1.80; 95 percent CI, 1.21 to 2.90) but not Crohn disease (OR, 1.48; 95 percent CI, 0.94 to 2.34). Gestational diabetes also occurred more often in women with IBD (OR, 2.96; 95 percent CI, 1.47 to 5.98). The pooled incidences of placental diseases were 2.0 percent (95 percent CI, 0.9 to 3.1 percent), 3.3 percent (95 percent CI, 0 to 7.2 percent), 0.5 percent (95 percent CI, 0.2 to 0.9 percent), and 0.3 percent (95 percent CI, 0 to 0.5 percent) for preeclampsia, placental abruption, placenta previa, and chorioamnionitis, respectively, in IBD. Preterm premature rupture of membranes was more likely among patients with IBD (OR, 12.10; 95 percent CI, 2.15 to 67.98), but early pregnancy loss was not (OR, 1.63; 95 percent CI, 0.49 to 5.43).

"Placental-related disorders, such as preeclampsia, placental abruption, and placenta previa, do not appear to be increased in this patient population," the authors write.

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