TY - JOUR
T1 - Does pregnancy change the disease course?
T2 - A study in a European cohort of patients with inflammatory bowel disease
AU - Riis, Lene
AU - Vind, Ida
AU - Politi, Patrizia
AU - Wolters, Frank
AU - Vermeire, Severine
AU - Tsianos, Epameinondas
AU - Freitas, João
AU - Mouzas, Ioannis
AU - Ruiz Ochoa, Victor
AU - O'Morain, Colm
AU - Odes, Selwyn
AU - Binder, Vibeke
AU - Moum, Bjørn
AU - Stockbrügger, Reinhold
AU - Langholz, Ebbe
AU - Munkholm, Pia
AU - European Collaborative Study Group on Inflammatory Bowel Disease
PY - 2006/7
Y1 - 2006/7
N2 - BACKGROUND AND AIMS: Inflammatory bowel disease (IBD) often affects patients in their fertile age. The aim of this study was to describe pregnancy outcome in a European cohort of IBD patients. As data are limited regarding the effect of pregnancy on disease course, our second objective was to investigate whether pregnancy influences disease course and phenotype in IBD patients.METHODS: In a European cohort of IBD patients, a 10-yr follow-up was performed by scrutinizing patient files and approaching the patients with a questionnaire. The cohort comprised 1,125 patients, of whom 543 were women. Data from 173 female ulcerative colitis (UC) and 93 Crohn's disease (CD) patients form the basis for the present study.RESULTS: In all, 580 pregnancies, 403 occurring before and 177 after IBD was diagnosed, were reported. The rate of spontaneous abortion increased after IBD was diagnosed (6.5% vs. 13%, p = 0.005), whereas elective abortion was not significantly different. 48.6% of the patients took medication at the time of conception and 46.9% during pregnancy. The use of cesarean section increased after IBD diagnosis (8.1% vs 28.7% of pregnancies). CD patients pregnant during the disease course, did not differ from patients who were not pregnant during the disease course regarding the development of stenosis (37% vs 52% p = 0.13) and resection rates (mean number of resections 0.52 vs 0.66, p = 0.37). The rate of relapse decreased in the years following pregnancy in both UC (0.34 vs 0.18 flares/yr, p = 0.008) and CD patients (0.76 vs 0.12 flares/yr, p = 0.004).CONCLUSIONS: Pregnancy did not influence disease phenotype or surgery rates, but was associated with a reduced number of flares in the following years.
AB - BACKGROUND AND AIMS: Inflammatory bowel disease (IBD) often affects patients in their fertile age. The aim of this study was to describe pregnancy outcome in a European cohort of IBD patients. As data are limited regarding the effect of pregnancy on disease course, our second objective was to investigate whether pregnancy influences disease course and phenotype in IBD patients.METHODS: In a European cohort of IBD patients, a 10-yr follow-up was performed by scrutinizing patient files and approaching the patients with a questionnaire. The cohort comprised 1,125 patients, of whom 543 were women. Data from 173 female ulcerative colitis (UC) and 93 Crohn's disease (CD) patients form the basis for the present study.RESULTS: In all, 580 pregnancies, 403 occurring before and 177 after IBD was diagnosed, were reported. The rate of spontaneous abortion increased after IBD was diagnosed (6.5% vs. 13%, p = 0.005), whereas elective abortion was not significantly different. 48.6% of the patients took medication at the time of conception and 46.9% during pregnancy. The use of cesarean section increased after IBD diagnosis (8.1% vs 28.7% of pregnancies). CD patients pregnant during the disease course, did not differ from patients who were not pregnant during the disease course regarding the development of stenosis (37% vs 52% p = 0.13) and resection rates (mean number of resections 0.52 vs 0.66, p = 0.37). The rate of relapse decreased in the years following pregnancy in both UC (0.34 vs 0.18 flares/yr, p = 0.008) and CD patients (0.76 vs 0.12 flares/yr, p = 0.004).CONCLUSIONS: Pregnancy did not influence disease phenotype or surgery rates, but was associated with a reduced number of flares in the following years.
KW - Adult
KW - Chi-Square Distribution
KW - Cohort Studies
KW - Disease Progression
KW - Europe/epidemiology
KW - Female
KW - Humans
KW - Inflammatory Bowel Diseases/epidemiology
KW - Phenotype
KW - Pregnancy
KW - Pregnancy Complications/epidemiology
KW - Pregnancy Outcome
KW - Statistics, Nonparametric
KW - Surveys and Questionnaires
U2 - 10.1111/j.1572-0241.2006.00602.x
DO - 10.1111/j.1572-0241.2006.00602.x
M3 - Journal article
C2 - 16863558
SN - 0002-9270
VL - 101
SP - 1539
EP - 1545
JO - The American Journal of Gastroenterology
JF - The American Journal of Gastroenterology
IS - 7
ER -