Perinatal outcomes in inflammatory bowel disease |
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Authors: | MC Bush S Patel RH Lapinski JL Stone |
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Affiliation: | Department of Obstetrics, Gynecology and Reproductive Science, Mount Sinai Medical Center, New York, New York, USA |
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Abstract: | Objective: To determine whether inflammatory bowel disease (IBD) is associated with increased risk for adverse perinatal outcome.Methods: A case–control study of 116 singleton pregnancies with IBD compared to 56?398 singleton controls delivered between 1986 and 2001.Results: Patients with IBD were slightly older (32.8 vs. 30.6 years, p 0.001), more likely to be Caucasian or Asian than Black or Latino (92% vs. 57%, p 0.001) and have private health insurance (33% vs. 3%, p 0.001). IBD was associated with an increased risk for labor induction (32% vs. 24%, p?=?0.002), chorioamnionitis (7% vs. 3%, p?=?0.04) and Cesarean section (32% vs. 22%, p?=?0.007), but there were no differences in neonatal outcomes. Subgroup analysis demonstrated an increased risk for low birth weight (LBW) in the ulcerative colitis group vs. the Crohn's disease group (19% vs. 0%, p?=?0.002). Patients with prior surgery for IBD had a lower incidence of LBW (0% vs. 12%, p?=?0.03). Flares during pregnancy were associated with an increased risk for preterm delivery (27% vs. 8%, p?=?0.02) and LBW (32% vs. 3%, p?=?0.003).Conclusion: IBD was an independent risk factor for Cesarean section but there was no increase in adverse perinatal outcome. Crohn's disease, prior IBD surgery and quiescent disease were associated with a lower risk for LBW. |
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Keywords: | INFLAMMATORY BOWEL DISEASE ULCERATIVE COLITIS CROHN'S DISEASE PREGNANCY LOW BIRTH WEIGHT CESAREAN SECTION |
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