Richard Y Wu1, Parul Tandon1,2, Lindsy Ambrosio3, Garett Dunsmore4, Naomi Hotte3, Levinus A Dieleman3, Shokrollah Elahi4,5,6, Karen Madsen3, Vivian Huang7,8. 1. Department of Medicine, University of Toronto, Toronto, Canada. 2. Division of Gastroenterology, Mount Sinai Hospital, 441 - 600 University Avenue, Toronto, ON, M5G 1X5, Canada. 3. Division of Gastroenterology, University of Alberta, Edmonton, Canada. 4. Department of Medical Microbiology and Immunology, University of Alberta, Edmonton, Canada. 5. Department of Dentistry, University of Alberta, Edmonton, Canada. 6. Department of Oncology, University of Alberta, Edmonton, Canada. 7. Division of Gastroenterology, Mount Sinai Hospital, 441 - 600 University Avenue, Toronto, ON, M5G 1X5, Canada. vivian.huang@sinaihealth.ca. 8. Division of Gastroenterology, University of Alberta, Edmonton, Canada. vivian.huang@sinaihealth.ca.
Abstract
BACKGROUND: Ulcerative colitis (UC) and Crohn's disease (CD) are chronic inflammatory bowel diseases (IBD) that affect women in their childbearing years. Early pregnancy flare-up negatively impacts obstetrical and perinatal outcomes, but the impact on infants is unclear. AIM: To determine whether active IBD disease activity is associated with adverse post-neonatal outcomes post-partum. METHODS: This is a single-center cohort study of women with IBD who underwent serial monitoring of post-neonatal outcomes post-partum. Infant outcomes were collected via self-filled questionnaires, including perinatal outcomes, APGAR scores, infant weights, heights, feeding habits and comorbidities within the first year of life. RESULTS: There was a total of 98 women with IBD and 78 live births throughout the study: 50 women were enrolled during trimester one alone and 49 were included into the current study. Among the 49 analyzed, 32 were in remission and 17 were in relapse during trimester one. Trimester one disease activity was associated with more adverse obstetrical outcomes including emergency C-sections and reduced 1-min APGAR scores. At follow-up, infants born to women with T1-flare had reduced weight-for-age Z scores and length-for-age Z scores up to 6 months of age. CONCLUSIONS: Active IBD during trimester one is correlated with adverse post-neonatal outcomes, particularly decreased infant weight and height up to 6 months of age. This suggests disease control in first trimester is essential for optimizing infant growth and post-neonatal outcomes.
BACKGROUND: Ulcerative colitis (UC) and Crohn's disease (CD) are chronic inflammatory bowel diseases (IBD) that affect women in their childbearing years. Early pregnancy flare-up negatively impacts obstetrical and perinatal outcomes, but the impact on infants is unclear. AIM: To determine whether active IBD disease activity is associated with adverse post-neonatal outcomes post-partum. METHODS: This is a single-center cohort study of women with IBD who underwent serial monitoring of post-neonatal outcomes post-partum. Infant outcomes were collected via self-filled questionnaires, including perinatal outcomes, APGAR scores, infant weights, heights, feeding habits and comorbidities within the first year of life. RESULTS: There was a total of 98 women with IBD and 78 live births throughout the study: 50 women were enrolled during trimester one alone and 49 were included into the current study. Among the 49 analyzed, 32 were in remission and 17 were in relapse during trimester one. Trimester one disease activity was associated with more adverse obstetrical outcomes including emergency C-sections and reduced 1-min APGAR scores. At follow-up, infants born to women with T1-flare had reduced weight-for-age Z scores and length-for-age Z scores up to 6 months of age. CONCLUSIONS: Active IBD during trimester one is correlated with adverse post-neonatal outcomes, particularly decreased infant weight and height up to 6 months of age. This suggests disease control in first trimester is essential for optimizing infant growth and post-neonatal outcomes.
Authors: Jacqueline G O'Leary; K Rajender Reddy; Puneeta Tandon; Scott W Biggins; Florence Wong; Patrick S Kamath; Guadalupe Garcia-Tsao; Benedict Maliakkal; Jennifer C Lai; Michael Fallon; Hugo E Vargas; Paul Thuluvath; Ram Subramanian; Leroy R Thacker; Jasmohan S Bajaj Journal: Dig Dis Sci Date: 2020-11-13 Impact factor: 3.199