Membranes In Women Research Articles

Description of Age and Parity with the Incidence of Premature Rupture of Membranes in Maternity Women at the Pulomerak Community Health Center

Premature rupture of membranes is a condition where the membranes rupture before delivery. Most of the premature rupture of membranes occurs at a gestational age of over 37 weeks, whereas at a gestational age of less than 36 weeks there are not too many. Premature rupture of the amniotic membranes causes the possibility of infection in the uterus, premature labor which will increase morbidity and death of the mother and fetus. There were 47 people experiencing premature rupture of membranes at the Pulo Merak Community Health Center in 2022. The aim of this research was to determine the description of maternal age and parity, with the incidence of premature rupture of membranes at the Pulomerak Community Health Center in 2022. The type of research used was descriptive research. The population in this study was all mothers giving birth at the Pulomerak Health Center for the period January - December 2022, totaling 194 people. The sample in this study was all mothers giving birth at the Pulomerak Health Center for the period January-December 2022, totaling 194 people. The sampling technique used in this research was a total sampling technique (non-probability sampling). The data source for this research is secondary data. The results of the research can be concluded that mothers who experienced PROM at the Pulomerak Community Health Center showed that 47 mothers experienced PROM, the proportion of Premature Rupture of Membranes occurred at ages <20 years and >35 years as many as 104 (53.6%). for parity in Multipara as many as 134 people (69%). The incidence of Premature Rupture of Membranes among women giving birth at the Pulomerak Community Health Center was higher at risk ages >20 years and <35 years at 32 people (31%). The incidence of premature rupture of membranes in women giving birth at the Pulomerak Community Health Center was higher in multiparas, 33 people (25%). The suggestion of this research is that health workers at the Pulomerak Community Health Center are expected to be able to maintain the performance that has been carried out, and maintain the quality of service in accordance with midwifery service standards. And for future researchers it can add broader & more accurate insight

Analysis of the Effects of Maternal Body Mass Index and Gestational Weight Gain on Maternal and Neonatal Outcomes in Twin Pregnancy

Objective: To investigate the effects of maternal body mass index (BMI) and gestational weight gain on maternal and neonatal outcomes in twin pregnancies. Methods: Five hundred cases of twin pregnancies were divided into a low body weight group (68 cases), a normal weight group (355 cases), an overweight group (65 cases), and an obesity group (12 cases) according to the World Health Organization (WHO) Body Mass Index (BMI) classification guidelines Results: Comparison of weight gain during different pregnancies revealed that pregnant women were mainly of low weight and average weight. The higher the BMI before pregnancy, the higher the incidence of excessive weight gain during pregnancy. The incidences of gestational diabetes mellitus (GDM) and premature rupture of membranes in women with low weight gain were significantly higher than those in women with average weight gain and high weight gain (P < 0.05). The incidences of gestational hypertension, preeclampsia, and anemia in women with high weight gain were significantly higher than those in women with low weight gain and average weight gain (P < 0.05). The incidence of neonatal birth weight, fetal distress, and macrosomia in the high weight gain group was significantly higher than those in the low weight gain and average weight gain groups (P < 0.05). The birth weight of newborns in low-weight gain mothers was significantly lower than that of normal-weight gain mothers (P < 0.05). Conclusion: Poor maternal and infant outcomes were common in women with insufficient or excessive weight gain during pregnancy. Therefore, for women with twin pregnancies, weight management is crucial to ensure maternal and infant health.

The effect of sedentary behavior during pregnancy on premature rupture of membrane in women above 35 years old.

Sedentary life is now considered among the main health risks globally among general population and pregnant women. Premature rupture of membranes is a serious pregnancy condition that is a main cause of newborn morbidity and death globally. There is very limited data about the effect of sedentary behavior during pregnancy on premature rupture of membranes. The current study set out to evaluate the impact of sedentary behavior during pregnancy on premature rupture of the membranes in women older than 35. A cohort prospective study was done on 90 pregnant women at Kasr Al-Ainy Hospitals. Participants were met three times (once per trimester). Routine labs and examinations were done and physical activities and sedentary behavior were assessed using prenatal physical activity questionnaire at each visit then pregnant women were followed up till rupture of membranes happened. A statistically significant difference was observed in the kind and intensity of physical activity among pregnant individuals at the first, second, and third trimesters. Women who experienced premature rupture of membranes demonstrated significantly lower levels of physical activity (household or caregiving, occupational, and low physical activities) and they also showed signs of a more sedentary lifestyle. Sedentary behavior during pregnancy had great effect on premature rupture of membranes in women above 35 years old. Sedentary participants were twice as likely to develop premature rupture of membranes in contrast to individuals who don't engage in sedentary behavior.

Immunosequencing and Profiling of T Cells at the Maternal-Fetal Interface of Women with Preterm Labor and Chronic Chorioamnionitis.

T cells are implicated in the pathophysiology of preterm labor and birth, the leading cause of neonatal morbidity and mortality worldwide. Specifically, maternal decidual T cells infiltrate the chorioamniotic membranes in chronic chorioamnionitis (CCA), a placental lesion considered to reflect maternal anti-fetal rejection, leading to preterm labor and birth. However, the phenotype and TCR repertoire of decidual T cells in women with preterm labor and CCA have not been investigated. In this study, we used phenotyping, TCR sequencing, and functional assays to elucidate the molecular characteristics and Ag specificity of T cells infiltrating the chorioamniotic membranes in women with CCA who underwent term or preterm labor. Phenotyping indicated distinct enrichment of human decidual effector memory T cell subsets in cases of preterm labor with CCA without altered regulatory T cell proportions. TCR sequencing revealed that the T cell repertoire of CCA is characterized by increased TCR richness and decreased clonal expansion in women with preterm labor. We identified 15 clones associated with CCA and compared these against established TCR databases, reporting that infiltrating T cells may possess specificity for maternal and fetal Ags, but not common viral Ags. Functional assays demonstrated that choriodecidual T cells can respond to maternal and fetal Ags. Collectively, our findings provide, to our knowledge, novel insight into the complex processes underlying chronic placental inflammation and further support a role for effector T cells in the mechanisms of disease for preterm labor and birth. Moreover, this work further strengthens the contribution of adaptive immunity to the syndromic nature of preterm labor and birth.

Maternal and neonatal outcomes of preterm prelabor rupture of membranes in women with and without cervical cerclage: a case control study

Maternal and neonatal outcomes of preterm prelabor rupture of membranes in women with and without cervical cerclage: a case control study

Risk Factors Associated with Early Preterm Premature Rupture of Membranes in Women with and without Early Preterm Premature Rupture of Membranes in Cameroon

Background: Preterm premature rupture of the membrane is an important cause of preterm birth. It often results in high perinatal morbidity and mortality in low-income nations. This study evaluated the risk factors associated with early PPROM among participants in Cameroon. Methods: This multi-centric case-control study was conducted in Douala and Yaoundé. We enrolled 125 participants with (cases) and 125 others without (controls) Preterm premature rupture of membrane. Consented participants were asked to fill in a structured questionnaire and data on their socio-demographic, physical, and clinical variables were collected. Descriptive statistic was carried out on SPSS version 23 to provide frequencies and percentages of respective parameters; also the Logistic regression was computerized to identify independent associations between participant’s characteristics, risk factors, and PPROM (Odds ratio at 95% CI, p< 0.05). Results: There were similarities in the characteristics of participants except for their profession whereby, the unemployed were more likely to be cases than controls [OR= 1.99; 95%CI: 1.20- 3.31; p= 0.007]. Among participants with PPROM, cases were more likely to have had a previous PPROM than controls [OR= 4.74 CI 95%: 1.08-20.79; p= 0.001]. Regarding their infection status, cases were more likely to have had Chlamydia Trachomatis infection [OR= 16.58; CI 95%: 3.08- 89.32; p= 0.001), or Bacterial vaginosis infection [OR= 16.58; CI 95%: 1.18-232.31; p= 0.001] than controls. Conclusion: Participants with the history of PPROM, Chlamydia Trachomatis infections and Bacterial vaginosis were more likely to have PPROM. As part of the preventive measure for a healthy pregnancy, pregnant women are advised to attend the antenatal clinic.

Prelabor rupture of membranes in women with gestational diabetes and the risk of neonatal hypoglycemia

Prelabor rupture of membranes in women with gestational diabetes and the risk of neonatal hypoglycemia

Prevalence and Factors Associated with Premature Rupture of Membranes in Denpasar Bali

Premature rupture of membranes (PROM) is an obstetric problem which is one of the factors causing prematurity, infection, malpresentation, umbilical cord prolapse and perinatal mortality. This study aims to identify the relationship between sociodemographic and obstetric factors with the premature rupture of membranes in women giving birth. This cross-sectional study involved 274 people from 859 deliveries from January to December 2020, at a referral hospital in Denpasar, Bali. The sampling technique used is simple random sampling. The process of collecting data was taken from medical records and hospital registers. Data analysis using chi-square and logistic regression. Study found that the prevalence of PROM was 22.6%. The results of multivariate analysis found that age (p=0.733), occupation (p=0.816), gestational age (p= 0.055), parity (p= 0.477), and intra uterine pressure (p= 0.105 ) were not associated with PROM. Educational factors (p=0.021), hemoglobin level (p=0.000), and history of PROM (p=0.005) were significantly related to the premature rupture of membranes. There is a relationship between education factors, hemoglobin levels and a history of PROM with premature rupture of membranes. This information is important for service providers to understand so that they can carry out early detection and treatment efforts to prevent PROM. Keywords: premature rupture of membranes, maternity mother, hemoglobin, education.

Antibody microarray analysis of amniotic fluid proteins associated with subsequent ruptured membranes in women with threatened preterm labor.

We aimed to identify amniotic fluid (AF) proteins associated with the subsequent rupture of membranes (ROM) occurring in the absence of active labor in women with threatened preterm labor (PTL) using an antibody microarray. This retrospective cohort study included 183 singleton pregnant women with PTL (24-33weeks) who underwent amniocentesis. A nested case-control study was conducted using AF samples from 20 women with subsequent ROM within 7days of sampling (case subjects) and 20 gestational age-matched women with term delivery (TD) without ROM (control subjects), via protein-antibody microarray analysis. Seven candidate proteins of interest were validated via ELISA in the total cohort. Seventeen proteins displayed significant intergroup differences. ELISA validation confirmed that the levels of EN-RAGE, Fas, IL-8, IP-10, MMP-8, and MMP-9 were significantly higher, whereas IGFBP-3 levels were significantly lower in the AF of women with subsequent ROM within 7days of sampling than in that of women with TD without ROM. Moreover, the time interval from sampling to membrane rupture was significantly correlated with the expression levels of AF proteins, except for IL-10. Using an antibody microarray, we identified various inflammatory, angiogenic, matrix-degrading, and apoptosis-related proteins in the AF that were associated with subsequent ROM occurring in the absence of active labor in women with threatened PTL. These findings provide novel insights into the molecular mechanisms underlying membrane rupture without active labor in threatened PTL.

The effect of low intensity ultrasound on neutrophil granulocytes of the mucous membranes and other factors of local immunity of women with Mycoplasma of urogenital system

Local and systemic physiotherapeutic effects using low intensity ultrasound for inflammatory diseases of the genitourinary system caused by M. genitalium are based on the stimulating effect of ultrasonic waves which allows to restore local immune status, eliminate the imbalance of neutrophil activity in the focus of the inflammatory reaction, and normalize the state of mucosal immunity factors of the mucous membranes in women with Mycoplasma infection of the genitourinary system.

The Association between Shirodkar Cerclage and Preterm Premature Rupture of Membranes in Singleton Pregnancies.

The aim of this study was to estimate if preterm premature rupture of membranes in women with cerclage is due to the cerclage itself or rather the underlying risk factors for preterm birth in this population. This was a retrospective cohort study of singleton pregnancies who underwent Shirodkar cerclage by a single maternal-fetal medicine practice between 2005 and 2019. The control group was an equal number of randomly selected women with a singleton gestation who had a prior preterm birth and were treated with 17-OH-progesterone but no cerclage. Patients with major uterine anomalies or fetal anomalies were excluded. The primary outcome was preterm premature rupture of membranes prior to 34 weeks. Chi-square and logistic regression were used. A total of 350 women with cerclage (154 [44%] history-indicated, 137 [39%] ultrasound-indicated, and 59 [17%] exam-indicated) and 350 controls were included. Preterm premature rupture of membranes prior to 34 weeks did not differ between the groups (8.9% in cerclage vs. 6.0% in controls, p = 0.149, adjusted odds ratio 0.62, 95% confidence interval: 0.24-1.64) nor between the different cerclage indications (9.1% of history-indicated, 7.3% of ultrasound-indicated, and 11.9% of exam-indicated, p = 0.582). This study had 80% power with an α error of 0.05 to detect an increase in preterm premature rupture of membranes prior to 34 weeks from 6.0% in the control group to 12.0% in the cerclage group. Cerclage does not increase the risk of preterm premature rupture of membranes prior to 34 weeks compared with other women at increased risk of preterm birth. The observed association between cerclage and preterm premature rupture of membranes is likely due to underlying risk factors and not the cerclage itself. The risk of preterm premature rupture of membranes prior to 34 weeks in women with cerclage is 10% or less and does not appear to differ based on cerclage indication. · Cerclage does not increase the risk of PPROM.. · Risk of PPROM with cerclage is approximately 10%.. · Risk does not appear to vary by indication..

MicroRNA-548 regulates high mobility group box 1 expression in patients with preterm birth and chorioamnionitis

High mobility group box 1 (HMGB1) is a prototypic alarmin and plays an important role in the pathogenesis of inflammatory process in spontaneous preterm birth. This study was conducted to compare the levels of HMGB1 in amniotic fluid and amnion membranes in women with chorioamnionitis/intra-amniotic inflammation to the levels in healthy controls. We also aimed to elucidate the involvement of microRNA-548 (miR-548) in regulating HMGB1 expression and its function in human amniotic epithelial cells (hAECs). A bioinformatics analysis predicted the binding of HMGB1 by the miR-548 cluster. A repressed and forced expression assay in hAECs was performed to investigate the causal relationship between the miR-548 cluster and HMGB1. The levels of HMGB1 in amniotic fluid and amnion membranes were significantly higher in patients with intra-amniotic inflammation/chorioamnionitis than in those without inflammation. The miR-548 was significantly under-expressed in amnion membranes from patients with chorioamnionitis than in normal term controls. Repressed expression of miR-548 up-regulated HMGB1 expression in hAECs and increased its release from hAECs. Moreover, forced expression of miR-548 suppressed HMGB1 and inflammatory cytokines in hAECs, which increased when treated with lipopolysaccharide. These results suggest miR-548 can alter the inflammatory responses in hAECs, and might be involved in the pathogenesis of preterm birth by regulating HMGB1.

THE STATE OF THE RED BLOOD CELL MEMBRANE IN IRON DEFICIENCY ANAEMIA IN WOMEN OF REPRODUCTIVE AGE

The problem of iron deficiency is urgent in many countries, regardless of the socio-economic standards of living. Among biomedical problems, the study of biochemical blood parameters is of paramount importance. A great interest in various aspects of this issue is not accidental, since the transport function of the blood largely depends on it and, consequently, the efficient delivery of oxygen, glucose, amino acids, fats, vitamins, mineral salts, hormones, mediators, antibodies and metabolites to the micro-zones in the tissues. The purpose of this article is to study the hematological status and the state of the red blood cell membrane in women of reproductive age suffering from iron deficiency anemia (IDA). Iron deficiency anemia (IDA) is a combination of clinical and hematological symptoms characterized by impaired hemoglobin formation due to iron deficiency in serum and bone marrow, as well as the development of trophic disorders in the organs and tissues. During the study, a complete blood count was performed using an enzyme-linked immunosorbent assay, using the kits produced by JSC Vector-Best, and the Kamyshnikov method. Based on the results of the study of the erythrocyte sorption capacity (ESC) in women of reproductive age with IDA, it was established that this parameter is 1.2 times higher than that in the control group. The development of anemia is associated with significant changes in the osmotic stability of the erythrocytes, which results in an increase in the proportion of both unstable and high-resistance erythrocytes. The scientific novelty of the article is that the authors established the key parameters for iron deficiency anemia detection.

Cerclage is associated with the increased risk of preterm birth in women who had cervical conization

BackgroundThe aim of this study was to determine the effect of cerclage in women who underwent cervical conization.MethodsStudy data were collected from the Korea National Health Insurance Claims Database of the Health Insurance Review and Assessment Service for 2009–2013. Women who had a conization in 2009 and a subsequent first delivery between 2009 and 2013 in Korea were enrolled.ResultsAmong the women who had conization in 2009, 1075 women had their first delivery between 2009 and 2013. A cerclage was placed in 161 of the women who were treated by conization. The rate of preterm birth was higher in the women who were treated with cerclage following a conization compared with those without cerclage (10.56 vs 4.27, p < 0.01, respectively). The multivariate regression analysis revealed that the women who were treated cerclage following a conization had an increased risk of preterm delivery compared with women without cerclage (odds ratio (OR), 2.6, 95% confidence interval (CI), 1.4–4.9).ConclusionOur study showed that cerclage associated with an increased risk of preterm birth and preterm premature rupture of membranes in women who underwent conization. Further studies are required to clarify the mechanism by which cerclage affects the risk of preterm birth.

Оксидативний стрес як важливий патогенетичний механізм розвитку змін репродуктивного здоров’я у жінок з соматоформними захворюваннями та порушенням вегетативного гомеостазу

The objective: to investigate the status of phospholipids and neutral lipids of blood cells in fertile aged women with violation of autonomic homeostasis and changes in reproductive health. Patients and methods. We examined 360 women with violation of autonomic homeostasis in the form of autonomic dysfunction syndrome and somatofom dysfunction of the autonomic nervous system of hypertonic, hypotonic and cardiac type and changes in reproductive health such as: artificial abortions, infertility and uterine leiomyoma. Results. The article presents data from a study of lipid peroxidation of cell membranes in fertile aged women with violation of autonomic homeostasis and changes in reproductive health. The obtained data of decay products concentrations of phospholipids and neutral lipids of cellular membranes indicate the ravages of free radical compounds to form intermediates and final products of lipid peroxidation. The results confirm the role of oxidative stress as an important pathogenetic mechanism of changes in the reproductive health of women with somatoform disorders and violations of autonomic homeostasis. Conclusion. Changes in the concentration of phospholipids, neutral lipids and lipid peroxidation products indicate a destabilizing effect on cell membranes in women with violation of autonomic homeostasis and reproductive health changes. Increasing the number of phospholipid degradation products show a decrease in the liquid component of cell membranes, which in turn changes the nature receptor interaction, as evidenced by a study hormonal and leads to disruption of feedback mechanisms concentration of hormones in the blood. Key words: oxidative stress, lipid peroxidation, women of fertile age, violations of autonomic homeostasis, changes in reproductive health.

Immunohistochemical evaluation of oestrogen receptors α and β in epithelium of the vaginal mucous membrane in women after oestrogen therapy.

Oestrogens act on target cells through α and β receptors (ERα and ERβ). Expression of oestrogen receptors is associated with the age and menopausal condition of women.The aim of the study was an immunohistochemical evaluation of ERα and ERβ receptors in epithelium of the vaginal mucous membrane of women subjected to different forms of hormonal therapy (HTM).Oestrogen receptors ERα and ERβ were identified using immunohistochemical methods and evaluated in smears of vaginal mucous membranes collected from 60 patients subjected to HTM (including 20 patients after oral therapy, 20 patients after transdermal therapy, and 20 patients after vaginal therapy). The results showed a significant change in immunoreactivity of both studied receptors after three months of hormone therapy. The biggest differences in the changes of intensity of ERα and ERβ reactions were observed in patients subjected to vaginal therapy. Immunostaining for α receptor showed differences between three types of hormone therapy. The highest increase in the overall intensity occurred after three months of topical therapy. Immunostaining for Erβ also varied for different types of hormone therapy.The results indicate that hormone therapy administered vaginally is the most effective in the treatment of urogenital ailments during menopause. In addition, topical therapy eliminates adverse effects of systemic oestrogen.

The use of semi-quantitative tests at Cesarean section delivery for the differentiation of canine fetal fluids from maternal urine on the basis of biochemical characteristics

In dogs, there is no diagnostic test to identify and differentiate fetal fluids from maternal urine in the event that a clear–yellowish vulvar discharge is observed pre-whelping. The objective of this study was to find a test that could easily and accurately identify rupture of the fetal membranes preceding parturition. Maternal urine, and amniotic fluid (AMF) and allantoic fluid (ALF) from only one fetus per bitch, were collected intraoperatively during Cesarean section. Specific gravity (SG) was analyzed with a refractometer, whereas the presence of leukocytes, protein, glucose, ketones, bilirubin, urobilinogen, nitrite, erythrocyte/hemoglobin (Hb), and the pH were assessed using a urine dipstick (Combur-Test®). Combined calcium and magnesium (Ca/Mg) content were evaluated with the Total Hardness Test. The AmniSure test, which detects rupture of fetal membranes in women on the basis of the presence of human placental alpha microglobulin-1, was also performed on canine AMF, ALF, and urine. Data were analyzed using the Fisher's exact test, Wilcoxon signed-rank test, and Pearson's correlation. Sensitivity, specificity, and positive and negative likelihood ratios (LR) were calculated for parameters with significant difference between urine and both fetal fluids. Maternal urine had higher SG and lower leukocyte, protein, Hb, and Ca/Mg content than AMF and ALF. Glucose was more often present in AMF (n = 17) and ALF (n = 12) than in urine (n = 1), whereas ketone bodies were rarely detected in ALF compared with urine. Bilirubin content was higher in urine and ALF than in AMF. AMF pH was less variable and higher than the pH of ALF or urine. The AmniSure was negative in all samples tested. Sensitivity and specificity for SG and for the detection of leukocytes, protein, glucose, Hb, Ca/Mg, and glucose without ketones in urine and fetal fluids were between 42% to 100% and 65% to 100%, respectively. Best positive LR was achieved for the detection of glucose without ketones and best negative LR for SG of 1.022 or less. In conclusion, the AmniSure test, which is used in humans with high diagnostic accuracy, cannot identify AMF and ALF in dogs. On the basis of our results in 26 dogs undergoing Cesarean section, the presence or absence of fetal fluids could be best determined by a positive glucose test without ketone bodies or by SG higher than 1.022, respectively. These tests may serve as additional tools to recognize parturition if clear–yellowish vulvar discharge is present in a term pregnant bitch, but their accuracy and practicability in the clinical setting need to be confirmed.

Accuracy of Conventional Digital Palpation and Ultrasound of the Cricothyroid Membrane in Obese Women in Labour

(Anaesthesia. 2015;70(11):1230–1234) The primary aim of this study was to determine the accuracy of identifying the cricothyroid membrane in women in labor using conventional digital palpation and ultrasonography. The study was undertaken at a teaching hospital in Canada and included “patient” and “participant” groups. The patient group included women between 37 and 40 weeks’ gestation who were in labor. Twenty-eight obese (body mass index &gt;30 kg/m2) and 28 nonobese women were enrolled in the study. Demographic data including age, weight, and height along with morphometric measurements (neck circumference, thyromental distance and sternomental distance) were obtained. The participant group (n=10) included anesthesia staff, fellows, and residents working in the labor and delivery unit of the hospital. They were randomized to palpate the cricothyroid membrane of an obese or nonobese parturient. The study design allowed a participant to participate more than once. These participants were randomized each time they participated. Among these ten, three participants palpated the cricothyroid membrane of nonobese patients only and 7 palpated the cricothyroid membrane of both obese and nonobese patients. Years of training and experience in performing cricothyroidotomy were recorded for each participant. No one had performed a cricothyroidotomy within the previous 12 months before the study.

Факторы риска преждевременного разрыва плодных оболочек у женщин с преждевременными родами в Кемеровской области

Факторы риска преждевременного разрыва плодных оболочек у женщин с преждевременными родами в Кемеровской области

Inflammatory Bowel Disease and Risk of Adverse Pregnancy Outcomes.

Background and ObjectivesExisting data on pregnancy complications in inflammatory bowel disease (IBD) are inconsistent. To address these inconsistencies, we investigated potential associations between IBD, IBD-related medication use during pregnancy, and pregnancy loss, pre-eclampsia, preterm delivery, Apgar score, and congenital abnormalities.MethodsWe conducted a cohort study in >85,000 Danish National Birth Cohort women who were pregnant in the period 1996-2002 and had information on IBD, IBD-related medication use (systemic or local corticosteroids, 5-aminosalicylates), pregnancy outcomes and potential confounders. We evaluated associations between IBD and adverse pregnancy/birth outcomes using Cox regression and log-linear binomial regression.ResultsIBD was strongly and significantly associated with severe pre-eclampsia, preterm premature rupture of membranes and medically indicated preterm delivery in women using systemic corticosteroids during pregnancy (hazard ratios [HRs] >7). IBD was also associated with premature preterm rupture of membranes in women using local corticosteroid medications (HR 3.30, 95% confidence interval [CI] 1.33-8.20) and with medically indicated preterm delivery (HR 1.91, 95% CI 0.99-3.68) in non-medicated women. Furthermore, IBD was associated with low 5-minute Apgar score in term infants (risk ratio [RR] 2.19, 95% CI 1.03-4.66). Finally, Crohn’s disease (but not ulcerative colitis) was associated with major congenital abnormalities in the offspring (RR 1.85, 95% CI 1.06-3.21). No child with a congenital abnormality born to a woman with IBD was exposed to systemic corticosteroids in utero.ConclusionWomen with IBD are at increased risk of severe pre-eclampsia, medically indicated preterm delivery, preterm premature rupture of membranes, and delivering infants with low Apgar score and major congenital malformations. These associations are only partly explained by severe disease as reflected by systemic corticosteroid use.