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* = Presenting author

P085 Pregnancy-onset IBD is not associated with adverse maternal or neonatal pregnancy outcomes

A. Shitrit*1, E. Goldin2, T. Adar2, B. Koslowsky2, D.M. Livovsky1, 2, S. Granovsky- Grisaru3

1Shaare Zedek Medical Center, Digestive Diseases Institute, Jerusalem, Israel, 2Shaare Zedek Medical Center, Digestive diseases institute, Jerusalem, Israel, 3Shaare Zedek Medical Center, Department of obstetrics and gynecology, division of maternal fetal medicine, Jerusalem, Israel

Background

Inflammatory bowel diseases (IBD), mainly Crohn's disease (CD) and ulcerative colitis (UC), may affect young female patients, including their childbearing years. In some cases, IBD may also first manifest during pregnancy (pregnancy-onset IBD). Given the fact immune tolerance during pregnancy may be associated with amelioration in disease severity; it may be intuitive to expect IBD cases which first manifest during pregnancy to have a more severe course, with possible adverse pregnancy outcomes. In our center, a dedicated IBD-MOM clinic, comprised of a multidisciplinary team, manages the diagnosis and treatment of IBD patients before, during and after pregnancy.We aimed to evaluate the pregnancy outcomes of female patients with pregnancy- onset IBD.

Methods

Data regarding pregnant patients with IBD is prospectively gathered at our IBD-MOM clinic. Out of the pregnancies followed during 2011-2014, patients whose IBD first manifested during pregnancy (pregnancy-onset IBD) were identified. Maternal and neonatal outcomes were compared between this group and those in the group of non-pregnancy onset IBD. Diagnosis of UC during pregnancy was performed by flexible sigmoidoscopy and mucosal biopsies. Diagnosis of CD during pregnancy was done by MRE and subsequently confirmed by colonoscopy and ileoscopy with mucosal biopsies post-partum. Statistical analysis was done to assess the profile of these two study populations including characteristics of their IBD and pregnancy outcome variables.

Results

During 2011-2014, 81 pregnancies of IBD patients were prospectively followed in our IBD-MOM clinic, 70 with previously known IBD, and 11 patients first diagnosed with IBD during pregnancy (mean age 29 ± 5 and 28 ± 5 years, respectively). Within the pregnancy-onset IBD, 4 patients were diagnosed with CD and 7 with UC compared to 46, 22, and 2 patients with CD, UC and IBD-undetermined respectively in the non pregnancy-onset IBD group. No differences were noted between the two groups in the ethnic origin, type of the disease, extent of disease involvement, pattern of IBD, need of steroids or hospitalization rate. Spontaneous vaginal delivery was achieved in 73% and 90%, respectively (p=0.48). Mean week of delivery was 38.3 ± 3 and 39.6 ± 1.3, respectively (p=0.11). Mean birth weight was 2942 ± 590 gram and 3167 ± 688, respectively (p= 0.27). Normal Apgar scores (9-10) were noted in most of the newborns in both groups (97% vs 100%, p= 0.72). Similar Postpartum exacerbation rate was observed (27% and 33%, p=0.48).

Conclusion

Pregnancy-onset IBD is not associated with negative impact on maternal or neonatal pregnancy outcomes compared to non pregnancy onset IBD.