Abstract
Background: Inflammatory bowel disease (IBD) is a term used to describe two conditions, Crohn’s disease and ulcerative colitis (UC), that currently have no definite cure. The incidence of IBD worldwide has increased, frequently affecting women during their reproductive years. Objectives: This study examines the association of Crohn's disease and ulcerative colitis (UC) with adverse pregnancy outcomes and looks at the interactions of race/ethnicity on these associations. Study Design: We examined hospital birth records in the National Inpatient Sample (NIS) data sets in 2011 and 2012. We identified maternal demographics and clinical characteristics using international classification of disease-9 codes. Chi-square and Fisher exact tests were used to examine associations and logistic regression models were used to control for confounders. Results: Crohn's disease is associated with small for gestational age, aOR 1.70(CI:1.53-1.89,p<0.001) but not premature delivery, whereas UC was associated with prematurity, aOR 1.5(CI:1.36-1.66,p<0.001) to a greater extent than with SGA. Analyses by race/ethnicity showed Crohn’s disease to be associated with SGA among newborns of all racial groups, but most evident among African Americans, aOR 2.55(CI:2.06-3.15,p<.001). Crohn’s disease was associated with prematurity only in Caucasian women, aOR 1.21(CI:1.10-1.34,p<.001). UC was associated with SGA newborns only in Hispanic mothers, aOR 3.40(CI:2.24-5.15,p<0.001), and with premature delivery only among Caucasian mothers, aOR 1.60(CI:1.42-1.80,p<.001). Conclusion: Both Crohn's disease and ulcerative colitis are associated with prematurity and small for gestational age in a way that is significantly affected by maternal race. Qualitative studies are needed to understand mechanisms for these associations and the role of race/ethnicity.
Highlights
Crohn’s disease and ulcerative colitis (UC) are two chronic relapsing and remitting diseases that currently have no definitive cure and together compromise a class of conditions known as inflammatory bowel disease (IBD).[1,2] In the United States, the incidence of Crohn’s disease has been 3.1 to 14.6 cases per 100,000 person years and the prevalence is 201 per 100,000 adults, whereas the incidence of UC is 2.2 to 14.3 cases per 100,000 person years and the prevalence is 238 per 100,000 adults.[1,2] Inflammatory bowel disease (IBD) has long been considered a problem of Western societies due to certain lifestyle factors thought to contribute to its pathogenesis.[3]
1.89,p
UC was associated with SGA newborns only in Hispanic mothers, aOR 3.40(CI:2.24-5.15,p
Summary
Crohn’s disease and ulcerative colitis (UC) are two chronic relapsing and remitting diseases that currently have no definitive cure and together compromise a class of conditions known as inflammatory bowel disease (IBD).[1,2] In the United States, the incidence of Crohn’s disease has been 3.1 to 14.6 cases per 100,000 person years and the prevalence is 201 per 100,000 adults, whereas the incidence of UC is 2.2 to 14.3 cases per 100,000 person years and the prevalence is 238 per 100,000 adults.[1,2] IBD has long been considered a problem of Western societies due to certain lifestyle factors thought to contribute to its pathogenesis.[3]. Previous studies have linked maternal IBD with low birthweight, small for gestational age (SGA), and preterm delivery outcomes in neonates. These studies were either conducted outside of the United States[712] or were limited to a small sample size.[13,14,15,16] a systematic review of past studies revealed inconsistencies in study size, quality and design, making it difficult to precisely assess the relationship between IBD and adverse birth outcomes.[17,18,19] In addition, the relationship between IBD and race/ethnic groups with regard to adverse birth outcomes has not been previously addressed. The incidence of IBD worldwide has increased, frequently affecting women during their reproductive years
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