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A national study of pregnancy-related maternal and fetal outcomes in women with inflammatory bowel disease

International Journal of Colorectal Disease volume 37, pages 1535–1543 (2022)Cite this article

Abstract

Background and aims

The incidence of inflammatory bowel disease (IBD) among women is highest during their reproductive years and current estimates suggest that the rate of conception is low in female IBD patients. The aim of our study was to assess the burden of adverse maternal and perinatal outcomes among female IBD patients.

Methods

Using the national inpatient sample database from 2016 to 2018, we recruited all female patients above the age of 15 years admitted with a primary diagnosis of pregnancy and a secondary diagnosis of IBD. We adjusted our results for hospital and patient level variables including age, race, socioeconomic status, hypertension, diabetes mellitus, obesity, smoking, hyperlipidemia, alcohol use, and malnutrition. Multivariable regression analysis was used for analysis.

Results

Pregnant women with IBD had greater odds of gestational diabetes (adjusted odds ratio [AOR] 1.55, 95% confidence interval [CI] 1.04–2.3, p 0.02), hypertensive complications (AOR 1.35, 95% CI 1.06–1.72, p 0.01), and pre-term delivery (AOR, 1.41 95% CI 1.13–1.76, p 0.003). Pregnancies with co-existent IBD were associated with fetal growth restriction (AOR 1.27, 95% CI 1–1.63, p 0.04) and fetal death (AOR 3.21, 95% CI 1.72–6.00, p < 0.01). Odds of experiencing postpartum hemorrhage or large for gestational age infant were comparable to general population. Crohn’s disease was independently associated with increased odds of worse maternal and fetal outcome. IBD patients had increased mean length of stay by 0.14 days and increased mean hospital charges of $2741.

Conclusions

Women with IBD had greater likelihood of poor maternal and fetal outcomes and increased hospital resource utilization.

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Fig. 1

Data availability

Study data can be shared on request.

Code availability

None.

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Authors and Affiliations

  1. Department of Medicine, University of Missouri School of Medicine, 1 Hospital Dr, Columbia, MO, USA

    Zahid Ijaz Tarar & Ghulam Ghous

  2. Loyola Medicine/MacNeal Hospital, Berwyn, IL, USA

    Umer Farooq

  3. Lehigh Valley Health Network, Allentown, PA, USA

    Muhammad Usman Zafar

  4. Department of Medicine, Sunrise Hospital and Medical Center, Las Vegas, NV, USA

    Saad Saleem

  5. Department of Medicine, Yale School of Medicine, New Haven, CT, USA

    Ahmad Nawaz

  6. Department of Gastroenterology, University of California, San Francisco, CA, USA

    Faisal Kamal

  7. Department of Medicine, Allama Iqbal Medical College, Lahore, Pakistan

    Faisal Inayat

  8. Division of Gastroenterology & Hepatology, School of Medicine at Columbia, University of Missouri, Columbia, MO, USA

    Yezaz A. Ghouri

Authors
  1. Zahid Ijaz Tarar
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  2. Umer Farooq
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  3. Muhammad Usman Zafar
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  4. Saad Saleem
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  5. Ahmad Nawaz
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  6. Faisal Kamal
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  7. Ghulam Ghous
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  8. Faisal Inayat
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  9. Yezaz A. Ghouri
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Contributions

ZT, UF, FK, SS, YG: concept and design of the study, data collection, data analysis, interpretation of results, writing of manuscript and final revision. GG, UZ, FI, AN: interpretation of results and manuscript writing. All authors approved the final version of manuscript.

Corresponding author

Correspondence to Zahid Ijaz Tarar.

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Competing interests

The authors declare no competing interests.

Ethics approval

This research study was conducted retrospectively from data obtained for clinical purposes. We consulted extensively with the IRB at the University of Missouri School of Medicine who determined that our study did not need ethical approval. An IRB official waiver of ethical approval was granted from the IRB.

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It is a retrospective study and consent is not required.

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It is a retrospective study and consent is not required.

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The authors declare no competing interests.

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Cite this article

Tarar, Z.I., Farooq, U., Zafar, M.U. et al. A national study of pregnancy-related maternal and fetal outcomes in women with inflammatory bowel disease. Int J Colorectal Dis 37, 1535–1543 (2022). https://doi.org/10.1007/s00384-022-04185-9

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  • DOI: https://doi.org/10.1007/s00384-022-04185-9

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