PTU-056Pregnancy outcomes in Patients with Crohn'S Disease: Lessons from Audit in a Specialist IBD Clinic

IntroductionCrohn's disease (CD) affects mainly people in their reproductive years. Concerns regarding family planning are the impact of CD on fertility and course of pregnancy,transmission to the offspring,issues concerning drug safety,mode of delivery and congenital anomalies. Published data is reassuring but awareness of outcomes locally can provide data regarding possible additional benefit from specialist obstetric medicine service.MethodsPregnant patients with CD were identified through the Electronic Patient Record System. Data were collected from October 2008-November 2012.Further information on outcomes was gathered from individual consultation with patients.Results80 pregnancies in 57 patients with CD were identified.10 patients currently pregnant,9 patients(13 pregnancies) with incomplete data were excluded.Therefore,pregnancy outcomes of 57 pregnancies/38 patients (mean age: 30.7 years) were analysed. 31/38(82%) of patients had luminal disease,7/38(18%) perianal disease.36/38(95%) conceived naturally,1/38(2.5%) by assisted reproduction,1/38(2.5%) by IVF.25/57(44%) pregnancies were on no treatment in early pregnancy, 4/57(7%) on biologics [Infliximab 3/4(75%),Adalimumab1/4(25%)],6/57(10%) on biologics+thiopurines(TPN),6/57(10%) on TPN,6/57(10%) on TPN+5-ASA,7/57(12%) on 5-ASA,2/57(3.5%) on steroids and 1/57(1.7%) on elemental diet.15/57(26%) pregnancies had flares,of which 5/15(33%) continued throughout pregnancy.5/15(33%) occurred in the 1st trimester,4/15(27%) in the 2nd, 1/15(7%) in the 3rd. Of all pregnancies with flares,9/15(60%) were on no CD therapy. The mean week of delivery was 39.5 weeks (36-42).32/46(70%) of deliveries were vaginal and 14/46(30%) by Caesarian section (CS).Of CS,8/14(57%) were planned due to perianal disease 5/8(63%) or obstetric indication 3/8(37%).Pregnancy outcomes were:live births 46/57(81%), miscarriages 10/57(17%), termination 1/57(2%). The mean birth weight (BW) of the newborns was 3 kg (1.9 kg-5.1 kg). 4/46(11%) of the babies were of low BW (