Pregnancy and inflammatory bowel disease in Greece: A prospective study of seven cases in a single hospital setting

J. K. Triantafillidis; G. Malgarinos; A. Gikas; Evi Delicha; Eleftheria Giannakoulopoulou; Asteria Stamataki; J. Fouskas; A. Mastrangelis; F. Georgopoulos; P. Cherakakis; A. Papadimitriou

Authors J. K. Triantafillidis, G. Malgarinos, A. Gikas, Evi Delicha, Eleftheria Giannakoulopoulou, Asteria Stamataki, J. Fouskas, A. Mastrangelis, F. Georgopoulos, P. Cherakakis, A. Papadimitriou.

Abstract

objective: Taking into account the relative confusion in the literature concerning the influence of pregnancy on the underlying inflammatory disease and vice versa, as well as the influence of drugs on the foetus and the gestation itself, we performed this prospective study, as data regarding this important clinical issue in Greece, are lacking. Patients and Methods: Prospective follow-up study of 7 pregnancies in 7 women with previously established IBD, 3 with ulcerative colitis and 4 with Crohn's disease. Results were compared to those of 7 women with inflammatory bowel disease (IBD) with similar clinicoepidemiological data but without gestation (disease control group), and 14 healthy pregnant women (healthy control group). Results: a)Patients with IBD and gestation vs healthy control group: Significantly
impaired body weight in newborns from IBD mothers
compared to healthy women (2,735+/-86 g vs 3,215+/-613g,
P=0.06) was found. Significantly more cases of spontaneous
abortion or premature delivery in pregnant women with IBD
compared to healthy pregnant women (3/7(43%) vs 1/14(7%), P=0.04 ) were also noticed. Concerning drug consumption it was noticed that azathioprine was taken regularly in one case of spontaneous abortion and in one case of premature delivery.
No significant differences concerning other parameters such as
smoking habit and death of foetus were observed. b) Patients
with IBD and gestation vs patients with IBD without gestation:
No significant differences in the history of various parameters
of the disease (number of operations, presence of fistulas), previous gestations, and course of the disease during gestation were found. c) Course of the disease six months after delivery:
No significant differences between patients with IBD and pregnancy and disease control group were noticed. Conclusion: It is concluded that the course of gestation in Greek women with IBD is accompanied by some unwanted events such as premature delivery, spontaneous abortion, and reduced body weight of the newborn. Clinicians must bear in mind the possibility of the appearance of some unwanted events in pregnant women with IBD during their gestation.
Key Words: Ulcerative colitis, Crohn's disease, Inflammatory
bowel disease, Pregnancy, outcome