ORLANDO, FLA. — Pregnancy does not cause relapse in patients with inflammatory bowel disease, and standard IBD treatments during pregnancy do not increase the risk of adverse fetal outcomes, a prospective case-control study suggests.
The findings of the 20-year study may give some peace of mind to the many women with IBD who are concerned about the effects of treatment on their fetus, and about the effects of pregnancy on the course of their disease. Until now, these women have had little to go on; the data regarding treatment effects and pregnancy outcomes in IBD have been scant and based only on cohort studies and registry data, Flavio M. Habal, M.D., said at the annual meeting of the American College of Gastroenterology.
He compared outcomes in 138 women with IBD who gave birth to a total of 174 infants over the course of the study, 83 case-matched nonpregnant controls with IBD, and 100 healthy pregnant controls. IBD relapses occurred in 18% of the case patients, compared with 23% of the control patients with IBD. The difference was not statistically significant, said Dr. Habal of the University of Toronto.
Furthermore, the relapse rate was significantly higher in the 50 case patients who were not on IBD maintenance therapy, compared with those who were on maintenance therapy (34% vs. 10%). Treatments used by case patients were oral 5-aminosalycilic acid (5-ASA) used by 58 patients, rectal 5-ASA (10 patients), prednisone (47 patients), and azathioprine (9 patients), he noted.
As for fetal outcomes, the mean birth weight of babies in the case patient group (3,210 g) was similar to the mean birth weight of babies in the healthy control patients (3,215 g), and the mean birth weight among babies of treated case patients (3,328 g) was significantly greater than the mean birth weight among babies of the untreated case patients (3,020 g).
Congenital anomalies occurred in fewer than 2% of the 174 babies in the case patient group, and in a comparable 4% of the 100 babies in the healthy pregnant controls.
Of note is that there were no relapses or congenital anomalies among the nine case patients treated with azathioprine, Dr. Habal said.