Understanding the Risks of Inflammatory Bowel Disease During Pregnancy: What Expecting Mothers Need to Know

Risks Associated with Inflammatory Bowel Disease in Pregnancy

Overview of the Study

A recent study has identified specific risks linked to inflammatory bowel disease (IBD) during pregnancy. Approximately 25% of patients diagnosed with IBD become pregnant, facing unique challenges throughout their gestation and delivery.

Key Findings

An analysis of 53 prior studies published in the journal *Alimentary Pharmacology & Therapeutics* highlighted several increased risks for pregnant women with IBD.

Delivery Methods and Complications

The review indicated that women with IBD have a heightened likelihood of requiring a cesarean section (C-section). Among all pregnant patients with IBD, one-third delivered via C-section, nearly double the rate seen in healthy women. Moreover, over half of those who had surgical deliveries experienced obstetric or neonatal complications, including labor arrest and fetal heart rate issues. Approximately 13% opted for C-sections due to concerns regarding perineal damage.

Gestational Diabetes and Other Risks

The study also found that women with IBD are at an elevated risk for gestational diabetes. Those affected by both IBD and gestational diabetes had a threefold increase in the likelihood of undergoing surgical delivery compared to women without these conditions. Additionally, the research noted a higher incidence of preterm prelabor rupture of membranes among patients with IBD.

Lack of Association with Placental Conditions

Interestingly, while many autoimmune disorders correlate with increased risks of placental-related issues such as pre-eclampsia and placental abruption, the study did not find this association in women with IBD.

Treatment Implications

Non-biologic therapies (5-ASA and thiopurines) and anti-TNF treatments typically used to manage IBD were not linked to negative pregnancy-related outcomes. These findings may bolster recent guidelines recommending the continuation of treatment during pregnancy to sustain disease remission.

Future Research Directions

Further studies are necessary to understand how the activity of inflammatory bowel disease influences pregnancy outcomes and to evaluate specific risks associated with different trimesters.

References

Tandon, P., Govardhanam, V., Leung, K., Maxwell, C., and Huang, V. (2020). Systematic review with meta-analysis: risk of adverse pregnancy-related outcomes in inflammatory bowel disease. *Alimentary Pharmacology & Therapeutics*, 51(3), pp.320-333.
EurekAlert!. (2020). Does inflammatory bowel disease carry certain risks during pregnancy?. [online] Available at: https://www.eurekalert.org/pub_releases/2020-01/w-dib010620.php [Accessed 28 Jan. 2020].
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