Ulcerative colitis and Crohn’s disease relapse risk varies during pregnancy: Study

Ulcerative colitis and Crohn’s disease – both inflammatory bowel diseases (IBDs) – relapse risk varies during pregnancy, according to research. The study revealed that women with active IBD near the time of conception have a higher risk of a relapse during pregnancy. Furthermore, women with ulcerative colitis have a higher risk of IBD relapse, compared to women with Crohn’s disease.

Researchers from Erasmus MC-University Medical Center in Rotterdam wrote, “The effects of active disease on birth outcomes have been reported earlier, although these outcomes do not seem representative in the era of biologicals. Also, the retrospective nature of these studies makes it difficult to determine how these pregnant patients were treated for their disease flare.”

The researchers studied the effects of IBD on relapse during pregnancy and birth outcomes.

The researchers followed 298 pregnancies and 226 live births, measuring disease activity and assessing birth outcomes. Majority of women were advised to continue with their IBD treatment during pregnancy and 93 percent adhered to their treatment plan. The researchers wrote, “Periconceptional disease activity was defined as active disease…at any time from eight weeks before conception until the first two weeks of pregnancy.”

Among the participants, 16.4 percent conceived while IBD was active and 29.7 percent had active disease during pregnancy. Within three months of delivery, 12.3 percent experienced a relapse.

After adjusting for other factors (namely, age and smoking status), the researchers found a strong link between disease activity around the time of conception and disease relapse during pregnancy.

The researchers concluded that all female IBD patients should be actively monitored during pregnancy, especially those women with ulcerative colitis.

“Birth outcomes in this cohort were more reassuring than in previous studies and underline that stringent follow-up of [women with IBD] during pregnancy will benefit mother and child,” the researchers said.

Inflammatory bowel disease during pregnancy

Living with inflammatory bowel disease not does usually affect pregnancy, and women with IBD can safely have healthy babies. IBD does not impact the course of pregnancy itself, but the risk of relapse is higher during this time or after the baby is born. Generally, if the disease is active at the conception, the odds of IBD activity throughout the pregnancy are quite high.

The IBD type and severity – as well as IBD treatment during pregnancy – may play a role in the odds of having a premature delivery. For example, women severe IBD are more likely to have a premature baby with a low birth weight.

Imaging tests are usually avoided during pregnancy in order to prevent harm to the fetus.

You will want to speak to your doctor regarding which medications are safe to take during pregnancy. In some cases, IBD severity is more harmful for the fetus than the medications to control the condition.