P507 Long term outcome of children born to IBD mothers: preliminary result from a multicenter retrospective study in the Netherlands
S. Kanis*1, A. De Lima1, Z. Zelinkova1, G. Dijkstra2, R. West3, R. Ouwendijk4, N. De Boer5, M. Pierik6, A. Van der Meulen- De Jong7, L. Oostenbrug8, M. Romberg- Camps9, A. Bodelier10, B. Oldenburg11, F. Hoentjen12, R. Beukers13, J. Jansen14, C. Van der Woude1
1Erasmus Medical Center, Gastroenterology and Hepatology, Rotterdam, Netherlands, 2UMC Groningen, Gastroenterology and Hepatology, Groningen, Netherlands, 3Sint Franciscus Gasthuis, Gastroenterology and Hepatology, Rotterdam, Netherlands, 4Ikazia Hospital, Gastroenterology and Hepatology, Rotterdam, Netherlands, 5VU University Medical Centre, Gastroenterology and Hepatology, Amsterdam, Netherlands, 6Maastricht University Medical Center+, Internal Medicine - Division Gastroenterology-Hepatology, Maastricht, Netherlands, 7LUMC Leiden, Gastroenterology and Hepatology, Leiden, Netherlands, 8Atrium Medical Center, Internal Medicine and Gastroenterology, Heerlen, Netherlands, 9ORBIS Medical Centre, Gastroenterology and Hepatology, Sittard, Netherlands, 10Amphia Hospital, Gastroenterology and Hepatology, Breda, Netherlands, 11UMC Utrecht, Gastroenterology and Hepatology, Utrecht, Netherlands, 12Radboud UMC, Gastroenterology & Hepatology, Nijmegen, Netherlands, 13Albert Schweitzer Hospital, Gastroenterology and Hepatology, Rotterdam, Netherlands, 14Onze Lieve Vrouwe Gasthuis, Gastroenterology and Hepatology, Amsterdam, Netherlands
The long term outcome of children born to mothers with inflammatory bowel disease(IBD) are relatively unexplored. The aim of this study is to analyze the health status of children who were born to mothers with IBD.
All women diagnosed with IBD prior to their pregnancy that gave birth between 1999 and 2011 were invited. After informed consent from both parents, the general practitioner (GP) was contacted for the following child outcomes: growth, number of infections for which antibiotics were needed, allergies and allergic reactions to vaccinations. Low birth weight was stated as <2500g, preterm birth as gestational age <37 weeks. The EUROCAT guideline was used to classify congenital abnormalities.
In total 935 invitations (in 2 rounds) were sent to women with IBD from 8 Dutch hospitals. The response was 46.8%(438). Until November 2014 362 children from 239 IBD mothers (257(71.0%) CD,93(25.7%)UC and 12(3.3%)IBDU) were included. Median child age at follow up was 6 years(IQR 4-11). In utero 118(32.6%) children were not exposed to any IBD drug, 97(26.8%) to only mesalazine, 79(21.8%) to thiopurine, 38 children(10.5%) to anti- TNF, 20(5.5%) to both anti- TNF and thiopurine and 10(2.8%) were unknown.
There was no difference in anti- TNF exposed and the non- exposed children considering; median gestational age (39 weeks(IQR 38-40)), pre- term births (67(18.5%)), overall birth weight (3268 gram(IQR 2893-3638)), low birth weight (40(11%)) and major congenital abnormalities (8(2.2%)).
Five(1.5%) children showed a primary or secondary growth deficiency. None of these children were exposed to anti- TNF. Apart from one extended rash after vaccination there were no reports of severe vaccination reactions. Overall 88 children had allergies. These allergies were more common in the non anti- TNF exposed children(36.9%) compared to the anti- TNF exposed children(15.7%)(p=0.03). Median number of infections was 1(IQR0-3). There was no difference in infections rate between anti- TNF exposed children compared to non- anti TNF exposed. Furthermore, there was no increased infection rate in thiopurine exposed children or children exposed to both anti- TNF and thiopurine.
In this long term follow-up study in children born to IBD mothers we show no major adverse events, an overall normal growth and development as compared to the Dutch population. Apart from a lower incidence of allergies no difference was observed between in utero anti-TNF exposed and non-exposed children.