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P156 Comparison of fetal risks in pregnancy before and after diagnosis of Inflammatory Bowel Disease: A prospective study

L. Kecili*, N. Bounab, N. Kaddache, K. Layaida, T. Boucekkine, N. Debzi, S. Berkane

CHU Mustapha, Gastroenterology, Alger, Algeria

Background

Inflammatory bowel disease (IBD) commonly affect young women during the reproductive years. The fetal prognosis of pregnancy occurring in IBD is generally considered as good.

Methods

To evaluate the impact of IBD on pregnancy (P), we studied the fetal outcome in 112 patients suffering from ulcerative colitis (UC) and 112 with Crohn's disease (CD), who have been pregnant before and / or after onset of disease.

In this prospective study we have compared during a 5 year period (1/1/2005 to 31/12/2009) outcome of the pregnancy which occurred before or after onset of disease.

Statistic study used Student Fisher's t test and Mann Whitney's U test

Results

- We recorded 303 pregnancies including 95 before diagnosis of UC and 208 after the disease, and 294 pregnancies including 88 before diagnosis of CD and 206 after the disease.

- Mean number of pregnancy was 0,84 and 1,85 in UC and 0,76 and et 1,84 in CD before and after the disease respectively.

- There was no statistical significant difference (SSD) as regards to fetal risk in UC considered before and after pregnancy.

- In CD, the rate of caesarean (10,7% Vs 4,5%), spontaneous abortion (6,8% Vs 2,5%), Stillborn (1,9% Vs 0%) were significantly higher after the diagnosis of the disease, than before.

- Comparing UC to CD , we found no statistical significant difference (SSD) as regards to fetal risk in UC and CD before the disease ; however, the rate of caesarean (10,7% Vs 4,9%) was higher in patients with CD after diagnosis.

- After diagnosis, the rate of caesarean (UC : 19,2% Vs 2,7% ; p<0,001 ; CD : 35,7% Vs 6,7% ; p<0,001), stillborn (UC : 3,8% Vs 1% ; p<0,8034 ; CD : 3,6% Vs 1,6% ; p<0,9426) and congenital abnormalities (UC : 3,8% Vs 0% ; p<0,2664 ; CD : 3,6% Vs 0,5% ; p<0,6505) were higher in primiparous than in multiparous patients.

Conclusion

However, CD in the post diagnosis phase and a primiparous statute have some negative influence on outcome of pregnancy; thus pregnancy in those IBD patients should be closely monitored.