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Bowel disease flare-ups affect pregnancy outcomes

NEW YORK (Reuters Health) - For pregnant women with inflammatory bowel disease, a relapse increases the risk that they’ll give birth prematurely and have a low-birth-weight infant, according to a new study.

Inflammatory bowel disease includes Crohn’s disease and ulcerative colitis. While treatment can keep the conditions under control, relatively little is known about treatment and response among women who experience a severe relapse during pregnancy -- and about the effect on the baby.

Dr. Deepa Reddy at Mount Sinai Medical Center in New York and colleagues compared 18 pregnant women with inflammatory bowel disease who were hospitalized for a disease relapse and 41 age-matched pregnant women with inflammatory bowel disease who did not relapse.

All 18 patients received intravenous hydrocortisone to control the inflammation and 7 were treated with additional immune suppressing drugs. While 15 had a clinical response to the treatments, 3 had to have a section of bowel removed, the team reports in the American Journal of Gastroenterology.

They found that the hospitalized patients delivered at an average of 35 weeks compared to almost 39 weeks for those in the comparison group.

Significant differences were also seen in preterm birth rates (70 percent and 7 percent) and in average birth weights (2001 grams and 3018 grams) between the two groups.

“All women with inflammatory bowel disease who become pregnant should be careful monitored, and aggressive control of disease activity prior to and during pregnancy is critical to optimize both maternal and fetal health,” the researchers conclude.

SOURCE: American Journal of Gastroenterology, May 2008.

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