P186 Pregnancy and natural history of Inflammatory Bowel Disease
L. Kecili*, N. Bounab, N. Kaddache, K. Layaida, T. Boucekkine, N. Debzi, S. Berkane
CHU Mustapha, Gastroenterology, Alger, Algeria
Inflammatory bowel disease (IBD) concern young women in age to procreate. The aim of this longterm and comparative study was to assess the influence of pregnancy on the outcome of IBD.
261 patients suffering from IBD were enrolled in the study from 1st January 2005 to 31 December 2009. They were divided in 2 groups according to their gestationnal statute: the 1first group (GI) included 224 pregnant patients at inclusion or already having had pregnancies (112 UC and 112 CD); the second group (GII) comprised 37 patients (17 UC and 20 CD) in age to procreate but never having had pregnancies. Statistical studies: Student Fisher's t test and Mann Whitney's U test.
- The comparison of GI and GII didn't show any statistically significant difference (SSD) on baseline or anatomoclinical characters as well in UC as in CD.
-During the course of the last pregnancy or in the post partum:
1/ in UC, when the disease was in remission at conception, the disease remained quiescent in 82% of the patients; relapses were noted in 18% of cases more often in the 1first quarter (64,3%) ; 78,6% of them were mild and healed under treatment. When pregnancy was concomitant to an active disease: a remission was observed in 77,7% of mild disease and 88,8% in moderate flares. Of the 6 severe cases recorded, one needed colectomy (16,7%).
2/ In CD, remission was maintened in 77, 3% of quiescent disease; 79,7% of the mild flares and 91% of moderate flares evolves towards complete remission; a surgical resection was necessary in 2 out of 8 severe colitis (25 %).
-Long term outcome was studied according to 4 items: Unchanged statute, improvement, worsening and need for surgery. The comparison of GI and GII didn't show any SSD in the outcome of UC; in CD a more favourable outcome in patients of the GII was observed.
The Results of this study show that the effect of pregnancy on the outcome of IBD depends, in UC as well as in CD, on the evolutive statute of the disease at conception. At long term, pregnancy had not a pejorative influence on the evolution of UC; CD's outcome has been worsened by gestations.