Inactive IBD, higher risk of preterm birth – DocCheck

A study by the University of Gothenburg has shown that inflammatory bowel disease in pregnant women increases the risk of premature birth. This applies even if the disease seems to have disappeared.

The collective term chronic inflammatory bowel disease (IBD) includes clinical pictures such as ulcerative colitis and Crohn’s disease, which – unlike irritable bowel syndrome – cause visible damage to the intestinal mucosa. A recurring tendency for symptom flare-ups followed by periods of little or no disease activity is characteristic.

Active disease – negative for pregnant women

Because IBD usually begins between the ages of 15 and 30, many patients are concerned about the effects on a possible pregnancy and fetus. Particularly in women with active disease, IBD is associated with negative birth outcomes such as preterm birth. But even patients without obvious disease activity often show microscopic inflammation in the intestinal mucosa. However, it was not yet known whether these irritations could be associated with risks in pregnancy.

Increased risk of premature birth

The Swedish research team therefore analyzed preterm birth rates in mothers who had IBD and for whom information was available on the microscopic appearance of the intestine just before pregnancy. The results are based on data from a registry of women in Sweden who were diagnosed with IBD between 1990 and 2016 and who had information on the microscopic appearance of the bowel shortly before pregnancy. The study included 1,223 children of women with microscopic intestinal inflammation of IBD and 630 children of women with IBD but with microscopically healed intestinal lining.

The registry linkage also obtained data from several national health registries, such as the Swedish Medical Birth Register and the Swedish Inflammatory Bowel Disease Quality Register (SWIBREG).

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aftermath

Current study published in the journal eClinical Medicine published show that microscopic inflammation in IBD, particularly in ulcerative colitis, is associated with an increased risk of preterm birth.

Of babies born to women with microscopic inflammation from IBD, 9.6% were born prematurely, while 6.5% of babies born to women without microscopic inflammation from IBD were born prematurely. This corresponds to a relative increase in risk of 46%. Microscopic inflammation was inconclusive with other adverse pregnancy outcomes such as: B. associated growth restriction.

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“Our results suggest that an IBD treatment that not only relieves the symptoms but also microscopically heals the intestine can reduce the risk of preterm birth,” says first author Professor Karl Mårild, Associate Professor of Pediatrics at the Sahlgrenska-Akademie and Chief Pediatric Specialist at the department. pediatrics at the Queen Silvia Children’s Hospital in Gothenburg. “If confirmed in future studies, our findings could form the basis for recommendations to ensure microscopic healing before pregnancy to reduce these risks.”

“Even a slightly increased relative risk of preterm birth is important, because preterm birth can seriously affect the health of the child in the short and long term. “Premature birth is still one of the leading causes of death for children under the age of five in Sweden,” concludes Mårild.

This text is based on a Swedish Research Council press release. We have a study for you here and referenced in the text.

Image credit: Arren Mills, unsplash.

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