Inflammatory bowel disease heightens risk of pregnancy and childbirth complications

Inflammatory bowel disease (IBD) is known for its debilitating effects within the digestive system, but research reveals risks for pregnant women who suffer from the condition. The findings come from a new study by scientists at the University of Missouri School of Medicine. Researchers examined the results of over 8 million pregnancies and the risks posed by IBD.

Inflammatory bowel disease describes Crohn’s disease and ulcerative colitis, which are generally identified by chronic inflammation of the gastrointestinal tract. IBD mainly affects younger people, especially women of peak reproductive age. Symptoms usually include diarrhea, fatigue, abdominal pain, and unintended weight loss.

“Because this disease tends to affect women during their peak fertility period, we wanted to know the impact of IBD on maternal and fetal outcomes. To our knowledge, this study is the most comprehensive of its kind, using data from multiple institutions in 48 states,” says senior author Yezaz Ghouri, MD, assistant professor of clinical medicine, in a statement. For this study, the team reviewed the pregnancies over the course of two years, spanning from 2016 to 2018. Of the 8 million, 14,129 mothers had been diagnosed with IBD.

The results showed the pregnant women with IBD had higher incidences of common pregnancy complications. These women suffered more from gestational diabetes, postpartum hemorrhaging, hypertension and preeclampsia, preterm delivery, fetal growth restriction, and fetal death. Further, they also had significantly longer hospital stays after delivery. On average, these women stayed an additional half-day and encountered over $2,700 more in related medical costs.   

Researchers believe that their study highlights the importance of women with IBD treating their condition with the primary goal of significantly reducing their complications, even before becoming pregnant. If not, they risk causing significant harm to themselves and their child, which can develop into lots of complications down the road.

“Based on our findings, we suggest that women who have moderate to severe IBD should get pre-conceptional counseling and be treated aggressively to achieve remission prior to getting pregnant,” explains Ghouri. “Our study results illustrate the importance that IBD be optimally controlled prior to conception.”  

 Previously, there haven’t been many studies on gut health and pregnancy, especially regarding how it may affect the outcome after birth. Similar IBD studies should be conducted, and this should also expand to related gut conditions like irritable bowel syndrome (IBS), celiac disease, and diverticulitis. All of these may also affect pregnancy in a similar fashion, and more extensive research can begin to explain why that is. Further, it can help medical professionals improve individualized care during the prenatal, delivery, and postpartum periods.

This study is published in the journal International Journal of Colorectal Disease.

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