P188 PREGNANCY OUTCOMES IN WOMEN WITH INFLAMMATORY BOWEL DISEASE: A 10-YEAR NATIONWIDE POPULATION-BASED COHORT STUDY

• Published in: Inflammatory bowel diseases 2018-01, Vol.24 (suppl_1), p.S74-S74
• Main Authors: Lee, Han Hee, Bae, Jung Min, Lee, Bo-In, Lee, Kang-Moon, Wie, Jeong Ha, Kim, Jin Su, Park, Jae Myung, Cho, Young-Seok, Jung, Sung-Ae, Kim, Sang Woo, Choi, Hwang, Choi, Myung-Gyu
• Format: Article
• Language: English
• ISSN: 1078-0998; 1536-4844
• DOI: 10.1093/ibd/izy038.026

Abstract Background and Aims Existing data regarding the association between inflammatory bowel disease (IBD) and pregnancy outcomes is lacking in Korea. Methods A nationwide population study was performed using the Korea National Health Insurance Claim Data between 2007 and 2016. A total of 2,058 patients with IBD consisting of ulcerative colitis (UC) (n=1,469) and Crohn's disease (CD) (n=589) were pregnant between 2008 and 2016 excluding 1-year washout period. We compared them to 20,580 age-matched controls without IBD for the incidence of pregnancy outcomes. We also stratified the patients into mild and severe IBD (defined as using steroid more than 6 months, using anti-TNF agents more than 1 year, or receiving colectomy) and compared the outcomes between them. Results Total pregnancy and birth rates of patients with IBD were lower than those of the controls (25.7% vs. 32.3%, 21.0% vs. 25.8%, respectively). Among the enrolled patients, 67.9% (1,397/2,058) have completed their pregnancy (n=999 in UC and n=398 in CD). Patients with CD were more likely than the controls to have a caesarean section (46.5% vs. 38.8%, odds ratio [OR] 1.429, 95% confidence interval [CI] 1.169-1.747), stillbirth (1.5% vs. 0.5%, OR 3.214, 95% CI 1.373-7.520), and intrauterine growth retardation (IUGR) (3.0% vs. 1.0%, OR 2.886, 95% CI 1.585-5.256), whereas patients with UC were not. Given the disease severity, the birth rate of severe IBD patients was lower than the controls (65.0% vs. 69.9%, OR 0.791, 95% CI 0.663-0.943). In addition, severe disease activity was significantly associated with spontaneous abortion (14.9% vs. 11.9%, OR 1.325, 95% CI 1.044-1.683), caesarean section (46.4% vs. 38.8%, OR 1.410, 95% CI 1.141-1.742), and IUGR (3.4% vs. 1.0%, OR 3.200, 95% CI 1.754-5.839). Conclusions Patients with IBD have lower pregnancy and birth rates. The risks of adverse pregnancy outcomes are increased in patients with CD or severe disease activity.