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Post-neonatal Outcomes of Infants Born to Women with Active Trimester One Inflammatory Bowel Disease: A Pilot Study

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Abstract

Background

Ulcerative colitis (UC) and Crohn’s disease (CD) are chronic inflammatory bowel diseases (IBD) that affect women in their childbearing years. Early pregnancy flare-up negatively impacts obstetrical and perinatal outcomes, but the impact on infants is unclear.

Aim

To determine whether active IBD disease activity is associated with adverse post-neonatal outcomes post-partum.

Methods

This is a single-center cohort study of women with IBD who underwent serial monitoring of post-neonatal outcomes post-partum. Infant outcomes were collected via self-filled questionnaires, including perinatal outcomes, APGAR scores, infant weights, heights, feeding habits and comorbidities within the first year of life.

Results

There was a total of 98 women with IBD and 78 live births throughout the study: 50 women were enrolled during trimester one alone and 49 were included into the current study. Among the 49 analyzed, 32 were in remission and 17 were in relapse during trimester one. Trimester one disease activity was associated with more adverse obstetrical outcomes including emergency C-sections and reduced 1-min APGAR scores. At follow-up, infants born to women with T1-flare had reduced weight-for-age Z scores and length-for-age Z scores up to 6 months of age.

Conclusions

Active IBD during trimester one is correlated with adverse post-neonatal outcomes, particularly decreased infant weight and height up to 6 months of age. This suggests disease control in first trimester is essential for optimizing infant growth and post-neonatal outcomes.

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Acknowledgments

We thank Dr. Richard Fedorak, Ms. Vivian Nguyen and Mr. Amit Aggarwal for helping this work. We also thank all the referring gastroenterologists, patients, nurses and research students that helped with this project.

Funding

The project is supported by local research supports from CEGIIR, University of Alberta Department of Medicine and Department of Gastroenterology, and the Mount Sinai Hospital, Department of Medicine.

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Authors and Affiliations

  1. Department of Medicine, University of Toronto, Toronto, Canada

    Richard Y. Wu & Parul Tandon

  2. Division of Gastroenterology, Mount Sinai Hospital, 441 – 600 University Avenue, Toronto, ON, M5G 1X5, Canada

    Parul Tandon & Vivian Huang

  3. Division of Gastroenterology, University of Alberta, Edmonton, Canada

    Lindsy Ambrosio, Naomi Hotte, Levinus A. Dieleman, Karen Madsen & Vivian Huang

  4. Department of Medical Microbiology and Immunology, University of Alberta, Edmonton, Canada

    Garett Dunsmore & Shokrollah Elahi

  5. Department of Dentistry, University of Alberta, Edmonton, Canada

    Shokrollah Elahi

  6. Department of Oncology, University of Alberta, Edmonton, Canada

    Shokrollah Elahi

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  1. Richard Y. Wu
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  2. Parul Tandon
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Contributions

RYW and PT participated in acquisition of data, analysis and interpretation of data; drafting the article and final approval of the version submitted. LA and GD participated in acquisition of data and analysis of data; revising critically for important intellectual content. NH was part of interpretation of data; revising critically for important intellectual content. LD, SE, KM and VH were part of conception and design of the study, analysis and interpretation of data; revising critically for important intellectual content. All authors approved the final version submitted.

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Correspondence to Vivian Huang.

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Wu, R.Y., Tandon, P., Ambrosio, L. et al. Post-neonatal Outcomes of Infants Born to Women with Active Trimester One Inflammatory Bowel Disease: A Pilot Study. Dig Dis Sci 67, 5177–5186 (2022). https://doi.org/10.1007/s10620-022-07430-x

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  • DOI: https://doi.org/10.1007/s10620-022-07430-x

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