Alison de Lima1, Zuzana Zelinkova2, Annemarie G M G J Mulders3, C Janneke van der Woude4. 1. Department of Gastroenterology and Hepatology, Erasmus MC-University Medical Hospital Rotterdam, Rotterdam, The Netherlands. 2. Department of Gastroenterology and Hepatology, Erasmus MC-University Medical Hospital Rotterdam, Rotterdam, The Netherlands; IBD Center, Thalion, Bratislava, Slovakia. 3. Department of Obstetrics and Gynaecology, Erasmus MC-University Medical Hospital Rotterdam, Rotterdam, The Netherlands. 4. Department of Gastroenterology and Hepatology, Erasmus MC-University Medical Hospital Rotterdam, Rotterdam, The Netherlands. Electronic address: c.vanderwoude@erasmusmc.nl.
Abstract
BACKGROUND & AIMS: Women with inflammatory bowel disease (IBD) may have incorrect beliefs about their disease and its medication in relation to pregnancy. We studied the effects of preconception care (PCC) on patients' behavior during pregnancy, disease relapse during pregnancy, and birth outcomes. METHODS: In a prospective study, we followed up all women with IBD seen at the preconception outpatient clinic at Erasmus MC-University Medical Center in Rotterdam, The Netherlands (from 2008 through 2014). We compared patients who received PCC before they became pregnant (PCC group; n = 155) with patients who visited the clinic after they already were pregnant (no-PCC group; n = 162). We collected data on lifestyle, medication adherence, planning of conception, disease activity, and birth outcomes. We compared adherence to medical advice, rates of disease relapse during pregnancy, and birth outcomes. RESULTS: The PCC group was on average younger than the no-PCC group (29.7 vs 31.4 y; P = .001), and a greater proportion were nulliparous (76.1% vs 51.2%; P = .0001). PCC was associated with adherence to IBD medication during pregnancy (adjusted odds ratio [aOR],5.69; 95% confidence interval [CI], 1.88-17.27), adequate folic acid intake (aOR, 5.26; 95% CI, 2.70-10.26), and smoking cessation (aOR, 4.63; 95% CI, 1.22-17.55). PCC reduced disease relapse during pregnancy independent of parity, disease duration, or disease activity before conception (aOR, 0.51; 95% CI, 0.28-0.95). The PCC group was less likely to deliver babies of low birth weight (aOR, 0.08; 95% CI, 0.01-0.48). CONCLUSIONS: In a prospective study, we found that preconception care reduces IBD relapse during pregnancy by promoting adherence to medication and smoking cessation. Preconception also reduces risk for babies of low birth weight.
BACKGROUND & AIMS:Women with inflammatory bowel disease (IBD) may have incorrect beliefs about their disease and its medication in relation to pregnancy. We studied the effects of preconception care (PCC) on patients' behavior during pregnancy, disease relapse during pregnancy, and birth outcomes. METHODS: In a prospective study, we followed up all women with IBD seen at the preconception outpatient clinic at Erasmus MC-University Medical Center in Rotterdam, The Netherlands (from 2008 through 2014). We compared patients who received PCC before they became pregnant (PCC group; n = 155) with patients who visited the clinic after they already were pregnant (no-PCC group; n = 162). We collected data on lifestyle, medication adherence, planning of conception, disease activity, and birth outcomes. We compared adherence to medical advice, rates of disease relapse during pregnancy, and birth outcomes. RESULTS: The PCC group was on average younger than the no-PCC group (29.7 vs 31.4 y; P = .001), and a greater proportion were nulliparous (76.1% vs 51.2%; P = .0001). PCC was associated with adherence to IBD medication during pregnancy (adjusted odds ratio [aOR],5.69; 95% confidence interval [CI], 1.88-17.27), adequate folic acid intake (aOR, 5.26; 95% CI, 2.70-10.26), and smoking cessation (aOR, 4.63; 95% CI, 1.22-17.55). PCC reduced disease relapse during pregnancy independent of parity, disease duration, or disease activity before conception (aOR, 0.51; 95% CI, 0.28-0.95). The PCC group was less likely to deliver babies of low birth weight (aOR, 0.08; 95% CI, 0.01-0.48). CONCLUSIONS: In a prospective study, we found that preconception care reduces IBD relapse during pregnancy by promoting adherence to medication and smoking cessation. Preconception also reduces risk for babies of low birth weight.
Authors: Ariella Bar-Gil Shitrit; Yael Cohen; Ori Hassin; Ami Ben Ya'acov; Rivkah Farkash; Benjamin Koslowsky; Yael Milgrom; Dan Meir Livovsky; Arnon Samueloff; Eran Goldin; Sorina Grisaru-Granovsky Journal: Dig Dis Sci Date: 2018-04-06 Impact factor: 3.199
Authors: Ashwin N Ananthakrishnan; Christopher Martin; Sunanda Kane; Robert S Sandler; Millie D Long Journal: Clin Gastroenterol Hepatol Date: 2018-04-11 Impact factor: 11.382
Authors: Sarah Wolloff; Emma Moore; Tracey Glanville; Jimmy Limdi; Klaartje B Kok; Aileen Fraser; Alexandra Kent; Khasia Mulgabal; Catherine Nelson-Piercy; Christian Selinger Journal: Frontline Gastroenterol Date: 2020-08-26