Inflammatory bowel disease (IBD) affects millions in the world. Both Ulcerative Colitis (UC) and Crohn's disease are severely debilitating and can present with varying degrees of inflammation in the digestive tract.
IBD can result in poor growth, malabsorption, and anemia. Serious complications such as bowel stenosis and perforation can result in the need for bowel surgery including removal of all or part of the large or small intestines.
In pregnancy there is a shift in the immune system and inflammatory mediators, and often some disease that are primarily inflammatory in nature often 'quite down'. Doctors in Denmark investigated the effect of pregnancy on IBD. Previous evidence exists on how IBD affects pregnancy outcome, but no studies to date have looked at how pregnancy affects future disease.
In the study, published in the July issue of American Journal of Gastroenterology, researchers enrolled 266 women who were pregnant with IBD. About 2/3 of the women had UC, while the others had Crohn's.
Timing of diagnosis, rate of relapse or flare-ups and pregnancy outcome was analyzed to determine if pregnancy had any effect on IBD course.
There were a total of 580 pregnancies during the study period. The rate of miscarriage was between 6 and 13 percent. Spontaneous abortion or miscarriage was twice as high for women who had a previous diagnosis of IBD before becoming pregnant. Cesarean section rates were slightly different between the groups; with previous diagnosis raising the likelihood delivery by c-section would be the outcome.
The rate of relapse was significantly lower after pregnancy. Women with a diagnosis prior to pregnancy had a lower rate of disease during the follow-up period. The authors could not determine from this study if the decrease in flare-ups was due directly to pregnancy or if there were other changes after delivery that affected relapse.
They feel that this preliminary evidence points to a possible effect of pregnancy on IBD relapse and that further studies are needed to determine the relationship.
Posted by Dr. Christina Gutierrez on August 31, 2006 11:23 AM
