Background: Inflammatory bowel disease (IBD) is a term used to describe two conditions, Crohn’s disease and ulcerative colitis (UC), that currently have no definite cure. The incidence of IBD worldwide has increased, frequently affecting women during their reproductive years.
Objectives: This study examines the association of Crohn's disease and ulcerative colitis (UC) with adverse pregnancy outcomes and looks at the interactions of race/ethnicity on these associations.
Study Design: We examined hospital birth records in the National Inpatient Sample (NIS) data sets in 2011 and 2012. We identified maternal demographics and clinical characteristics using international classification of disease-9 codes. Chi-square and Fisher exact tests were used to examine associations and logistic regression models were used to control for confounders.
Results: Crohn's disease is associated with small for gestational age, aOR 1.70(CI:1.53-1.89,p<0.001) but not premature delivery, whereas UC was associated with prematurity, aOR 1.5(CI:1.36-1.66,p<0.001) to a greater extent than with SGA. Analyses by race/ethnicity showed Crohn’s disease to be associated with SGA among newborns of all racial groups, but most evident among African Americans, aOR 2.55(CI:2.06-3.15,p<.001). Crohn’s disease was associated with prematurity only in Caucasian women, aOR 1.21(CI:1.10-1.34,p<.001). UC was associated with SGA newborns only in Hispanic mothers, aOR 3.40(CI:2.24-5.15,p<0.001), and with premature delivery only among Caucasian mothers, aOR 1.60(CI:1.42-1.80,p<.001).
Conclusion: Both Crohn's disease and ulcerative colitis are associated with prematurity and small for gestational age in a way that is significantly affected by maternal race. Qualitative studies are needed to understand mechanisms for these associations and the role of race/ethnicity.
Birth outcomes, Crohn's disease, inflammatory bowel disease, prematurity, ulcerative colitis
The authors report no conflict of interest.
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Department of Obstetrics and Gynecology, The University of Iowa Hospitals and Clinics
Saeed Z, Aly H, Macri C, Abdelatif D, Mohamed MA. Maternal inflammatory bowel disease, racial diversity and adverse birth outcomes.. POG in Press. 2020 June; Article 2 [ 16 p.]. Available from: http://ir.uiowa.edu/pog_in_press/. Free full text article.