A Survey of Pregnancy Outcomes for Women of Childbearing Age with Inflammatory Bowel Disease in South China

Abstract

Purpose: Women of childbearing age with inflammatory bowel disease (IBD) in South China were studied to understand the effects of IBD on pregnancy outcomes. Materials and Methods: One hundred thirty-nine women treated at two large IBD centers participated. Pregnancy outcome data were collected by telephone interviews. Results: Ninety patients (90/139; 64.7%) did not pursue pregnancy after IBD diagnosis because of concerns regarding adverse effects. Fifteen Crohn’s disease (CD) and 12 ulcerative colitis (UC) patients pursued pregnancy and achieved successful conception. Twenty-five patients were treated with drugs before pregnancy; however, 15 (15/25; 60%) discontinued the use of all drugs 3 months before pregnancy. The other 10 patients continued mesalazine and one continued azathioprine during pregnancy. Four CD and five UC patients had mild disease at conception; the others were in remission. Two CD patients and one UC patient experienced mild disease relapse during pregnancy. They refused all drugs except mesalazine. One UC patient with mild disease during pregnancy had pregnancy-induced hypertension. All newborns were healthy. There was no difference between pregnancy outcomes of CD and UC patients (P > 0.05). No relationship was found between disease activity and pregnancy outcomes (P > 0.05). Patients with active disease during pregnancy tended to choose cesarean delivery, especially in CD patients with active disease (P = 0.028). Conclusion: Many female IBD patients may not pursue pregnancy because of concerns regarding adverse effects on the pregnancy. Patients were more willing to conceive during disease remission. Some refused all IBD medications except mesalazine. Relapse was uncommon or mild during pregnancy. Disease activity had an obvious effect on the delivery mode of CD patients.