To examine characteristics and outcomes of pregnant individuals with inflammatory bowel disease (IBD). This is a retrospective cohort study using linked vital statistics-hospital discharge data from California (2007-2011).We utilized singleton, non-anomalous deliveries and compared demographics and outcomes of cesarean delivery (CD), preterm delivery (< 37 weeks), preeclampsia, operative vaginal delivery, postpartum hemorrhage, placenta previa, and placental abruption using chi-square test. We then performed multivariate logistic regressions controlling for age, race/ethnicity, education, and insurance status. The cohort consisted of 1,807 (0.06%) individuals with IBD and 2,807,941 (99.94%) without IBD. IBD patients were more likely to be white, older, highly educated, on private insurance, normal BMI, have attended ≥ 5 prenatal visits, live in urban areas, and speak English as their primary language (p< 0.001 for all) than those without IBD. On multivariate logistic regression, IBD patients were more likely to have a CD (aOR 1.77, 95% CI 1.59-1.97), preterm delivery (aOR 2.26, 95% CI 1.96-2.61), preeclampsia (aOR 1.29, 95% CI 1.04-1.60), or placenta previa (aOR 1.81, 95% CI 1.19, 2.77), but did not have statistically significant operative vaginal delivery (aOR 1.09, 95% CI 0.93,1.30), postpartum hemorrhage (aOR 1.16, 95% CI 0.88,1.53), or placental abruption (aOR 1.45, 95% CI 0.97, 2.20). Our cohort of IBD patients had characteristics that typically contribute to favorable birth outcomes, but they were more likely to experience CD, preterm birth, preeclampsia, placenta previa, placental abruption, and postpartum hemorrhage. After adjusting for confounders, the rates of postpartum hemorrhage, and placental abruption no longer differed between groups. These results indicate that IBD is most likely responsible for some adverse pregnancy outcomes, but further work should assess disparities that occur among IBD patients that drive adverse outcomes.View Large Image Figure ViewerDownload Hi-res image Download (PPT)