S0886 Pregnancy Complications in Women With Inflammatory Bowel Disease: Results From the National Inpatient Sample

Abstract

INTRODUCTION: Previous studies have been inconsistent in regard to the risk of pregnancy-related complications in women with IBD. METHODS: This was a case-control study using the 2014 USA National Inpatient Sample (NIS) to measure the frequency of an ICD9 code for a pregnancy complication in women with IBD versus no IBD. Pregnancy complications included spontaneous abortion, post abortion complications, ectopic pregnancy, hemorrhage, hypertensive disorders, early labor, polyhydramnios, prolonged pregnancy, gestational diabetes, fetal distress, umbilical cord complications, obstetric trauma, hyperemesis, missed abortion, mental disorder during pregnancy, forceps delivery, infections and anemia. We performed univariate and multivariate logistic regression controlling for confounders predisposing to pregnancy complications including antiphospholipid syndrome, SLE, hyperthyroidism, hypothyroidism, chlamydia, gonorrhea and cervical incompetence. RESULTS: 3262595 women ages 18–35 were discharged on 2014 with a pregnancy complication. From this cohort, 6705 (0.21%) had IBD. The mean age for cases and controls was 29 and 27 years respectively. Cases were more likely to be Caucasian (78% vs 54%) and be admitted to urban academic hospitals along with a slightly higher mortality risk (Table 1). In multivariate analyses, there was no statistically significant difference (P > 0.05) between cases and controls for: spontaneous abortion, post abortion complications, ectopic pregnancy, hemorrhage, severe preeclampsia, eclampsia, early labor, polyhydramnios, hyperemesis, missed abortion, mental disorder during pregnancy and forceps delivery. When compared to women with no IBD, women with IBD had lower odds (P < 0.05) for prolonged pregnancy, gestational diabetes, fetal distress, umbilical cord complications, obstetric trauma, mild preeclampsia and hypertension. There was however higher odds for infectious and parasitic complications (OR 1.74 95% CI 1.42–2.14, P < 0.0001), UTIs (OR 1.65 95% CI 1.07–2.60 P = 0.02) and anemia (OR 5.26 95% CI 4.01–6.90 P < 0.0001) (Table 2). CONCLUSION: In this large nested case-control study, women with IBD did not have a higher risk of common pregnancy complications compared with non-IBD mothers. There was a higher risk for infection and anemia, likely secondary to the immunosuppressive medications used in treatment and the disease itself. These data are important to share with women with IBD considering pregnancy.Table 1.: Demographics and risk factors for pregnancy-related complications in hospitalized women with and without IBDTable 2.: Multivariate analysis for odds of pregnancy-related complications in women with IBD versus women with no IBD