117: Is there neonatal risk associated with biologic exposure in pregnancies affected by inflammatory bowel disease?

Abstract

Biologic use to treat inflammatory bowel disease (IBD) during pregnancy has become more prevalent; however, few studies have examined the neonatal risk of biologic exposure in utero. We sought to evaluate the impact of biologic use on neonatal outcomes in pregnancies affected by inflammatory bowel disease. This was a retrospective study of patients with IBD who were pregnant and delivered at a single tertiary care institution from 2012 to 2017. Neonatal adverse outcome was defined as a composite outcome of preterm birth, small for gestational age (SGA), neonatal infection, or NICU admission. Incidence of the neonatal adverse outcome was compared between patients that used a biologic versus those that did not using a Chi-square test. Of the 273 patients included in this analysis, 72 (26.4%) used biologics. Overall, mean maternal age was 32.9 ±5.1 years, mean BMI was 24.4 ±4.6, 82.8% of the patients were Caucasian, and 35.4% of patents were advanced maternal age (>= 35 years). Demographics were similar between biologic users and non-users (Table 1). There was one neonatal death in the group not exposed to biologics which was due to hypoxic ischemic encephalopathy secondary to perinatal asphyxia as a result of feto-maternal hemorrhage. The use of biologics in utero was not associated with an increased risk of neonatal adverse outcome (14/70 (20.0%) versus 49/196 (25.0%), p = 0.40). The use of biologics for inflammatory bowel disease during pregnancy was not associated with an increased risk of adverse neonatal outcome. Future studies should evaluate the long term outcomes of neonates exposed to biologics in utero.View Large Image Figure ViewerDownload Hi-res image Download (PPT)