Predictors of disease activity during pregnancy in women with inflammatory bowel disease—a Danish cohort study
Summary Background and Aims Inflammatory bowel disease (IBD) activity during pregnancy is associated with adverse pregnancy outcomes. We aimed to identify key clinical characteristics that predict disease activity during pregnancy. Methods Between January 2008 through 2021, we identified all singlet...
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| Veröffentlicht in: | Alimentary pharmacology & therapeutics 2023-02, Vol.57 (3), p.335-344 |
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| creator | Vestergaard, Thea Julsgaard, Mette Røsok, Julie F. Vestergaard, Søren V. Helmig, Rikke B. Friedman, Sonia Kelsen, Jens |
| description | Summary
Background and Aims
Inflammatory bowel disease (IBD) activity during pregnancy is associated with adverse pregnancy outcomes. We aimed to identify key clinical characteristics that predict disease activity during pregnancy.
Methods
Between January 2008 through 2021, we identified all singleton pregnancies among women with IBD recorded in patient and birth registries at a tertiary IBD centre in Denmark. Maternal and infant data were retrieved from medical records. Demographics, Physicians Global Assessment (PGA) of disease activity 6 months prior to pregnancy and in all three trimesters of pregnancy and pregnancy outcomes were recorded.
Results
In 609 pregnancies, we observed 603 (99.0%) live births. Disease activity in one or more trimesters was seen in 283 women (46.5%). UC phenotype was associated with an increase in risk of disease activity (adjusted OR = 2.6 [1.8–3.9]; p |
| doi_str_mv | 10.1111/apt.17348 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2754504829</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2765452030</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3888-c824fa2dc9d08fcb2c01a58f853d1a7fe61152ff5f0112dc7b0d20acc59d43703</originalsourceid><addsrcrecordid>eNp10ctKxDAYBeAgio6jC19AAm50USdJmzZdDuMVBF3ouqS5OJG2qUnr0J0P4RP6JGas40Iwi4TAl0P4DwBHGJ3jsGa87c5xFidsC0xwnNKIoDjdBhNE0jwiDMd7YN_7F4RQmiGyC_aCwUlOswloH5ySRnTWeWg1lMYr7hXkojNvphug7J1pnmHr1HPDGzFA08CVrVXYTbcMN13xuubh_QBLu1LVJuLz_YPDC94Yv4TCLq3roO96ORyAHc0rrw5_zil4urp8XNxEd_fXt4v5XSRixlgkGEk0J1LkEjEtSiIQ5pRpRmOJeaZVijElWlONMA4sK5EkiAtBc5nEGYqn4HTMbZ197ZXvitp4oaqKN8r2viAZTShKGMkDPflDX2zvmvC7oNLAwjjXgWejEs5675QuWmdq7oYCo2JdQxFqKL5rCPb4J7EvayV_5WbuAcxGsDKVGv5PKuYPj2PkFyAqk-M</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2765452030</pqid></control><display><type>article</type><title>Predictors of disease activity during pregnancy in women with inflammatory bowel disease—a Danish cohort study</title><source>MEDLINE</source><source>Wiley Online Library Free Content</source><source>Wiley Online Library Journals</source><source>EZB Electronic Journals Library</source><creator>Vestergaard, Thea ; Julsgaard, Mette ; Røsok, Julie F. ; Vestergaard, Søren V. ; Helmig, Rikke B. ; Friedman, Sonia ; Kelsen, Jens</creator><creatorcontrib>Vestergaard, Thea ; Julsgaard, Mette ; Røsok, Julie F. ; Vestergaard, Søren V. ; Helmig, Rikke B. ; Friedman, Sonia ; Kelsen, Jens</creatorcontrib><description>Summary
Background and Aims
Inflammatory bowel disease (IBD) activity during pregnancy is associated with adverse pregnancy outcomes. We aimed to identify key clinical characteristics that predict disease activity during pregnancy.
Methods
Between January 2008 through 2021, we identified all singleton pregnancies among women with IBD recorded in patient and birth registries at a tertiary IBD centre in Denmark. Maternal and infant data were retrieved from medical records. Demographics, Physicians Global Assessment (PGA) of disease activity 6 months prior to pregnancy and in all three trimesters of pregnancy and pregnancy outcomes were recorded.
Results
In 609 pregnancies, we observed 603 (99.0%) live births. Disease activity in one or more trimesters was seen in 283 women (46.5%). UC phenotype was associated with an increase in risk of disease activity (adjusted OR = 2.6 [1.8–3.9]; p < 0.001). Disease activity within 6 months prior to conceiving (169 women [27.7%]) was associated with an increased risk of continuous disease activity during pregnancy (adjusted OR of 5.3 [3.5–8.2]; p < 0.001). Disease activity during a previous pregnancy was associated with an increased risk of flares in subsequent pregnancies (adjusted OR of 3.2 [1.5–6.6]; p = 0.002). Sustained clinical remission throughout pregnancy was associated with an increased probability of normal birth term, birthweight and low risk of fetal growth restriction (FGR) and stillbirth.
Conclusion
Predictors for disease activity include disease activity in a previous pregnancy and/or prior to conception, as well as UC phenotype. Reassuringly, women with IBD in remission are not at increased risk of adverse pregnancy outcomes.
Odds ratio of alternating disease courses in subsequent pregnancies, UC and CD combined. Odds ratio of experiencing disease activity during pregnancy depending on occurrence of disease activity within 6 months of conception and attainment of remission at time of conception. Odds ratio of experiencing disease activity during pregnancy depending on IBD subtype.</description><identifier>ISSN: 0269-2813</identifier><identifier>EISSN: 1365-2036</identifier><identifier>DOI: 10.1111/apt.17348</identifier><identifier>PMID: 36514957</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Birth weight ; Cohort analysis ; Cohort Studies ; Denmark - epidemiology ; disease activity ; Female ; Fetuses ; Humans ; IBD ; Inflammatory bowel disease ; Inflammatory bowel diseases ; Inflammatory Bowel Diseases - diagnosis ; Inflammatory Bowel Diseases - epidemiology ; Intestine ; Medical records ; Phenotypes ; Pregnancy ; Pregnancy Complications - diagnosis ; Pregnancy Complications - epidemiology ; Pregnancy Outcome ; Remission ; Remission (Medicine) ; Risk assessment ; risk factors ; Stillbirth ; Womens health</subject><ispartof>Alimentary pharmacology & therapeutics, 2023-02, Vol.57 (3), p.335-344</ispartof><rights>2022 The Authors. published by John Wiley & Sons Ltd.</rights><rights>2022 The Authors. Alimentary Pharmacology & Therapeutics published by John Wiley & Sons Ltd.</rights><rights>2022. This article is published under http://creativecommons.org/licenses/by-nc/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3888-c824fa2dc9d08fcb2c01a58f853d1a7fe61152ff5f0112dc7b0d20acc59d43703</citedby><cites>FETCH-LOGICAL-c3888-c824fa2dc9d08fcb2c01a58f853d1a7fe61152ff5f0112dc7b0d20acc59d43703</cites><orcidid>0000-0002-5373-8661 ; 0000-0003-3070-8950</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fapt.17348$$EPDF$$P50$$Gwiley$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fapt.17348$$EHTML$$P50$$Gwiley$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,1411,1427,27903,27904,45553,45554,46387,46811</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36514957$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Vestergaard, Thea</creatorcontrib><creatorcontrib>Julsgaard, Mette</creatorcontrib><creatorcontrib>Røsok, Julie F.</creatorcontrib><creatorcontrib>Vestergaard, Søren V.</creatorcontrib><creatorcontrib>Helmig, Rikke B.</creatorcontrib><creatorcontrib>Friedman, Sonia</creatorcontrib><creatorcontrib>Kelsen, Jens</creatorcontrib><title>Predictors of disease activity during pregnancy in women with inflammatory bowel disease—a Danish cohort study</title><title>Alimentary pharmacology & therapeutics</title><addtitle>Aliment Pharmacol Ther</addtitle><description>Summary
Background and Aims
Inflammatory bowel disease (IBD) activity during pregnancy is associated with adverse pregnancy outcomes. We aimed to identify key clinical characteristics that predict disease activity during pregnancy.
Methods
Between January 2008 through 2021, we identified all singleton pregnancies among women with IBD recorded in patient and birth registries at a tertiary IBD centre in Denmark. Maternal and infant data were retrieved from medical records. Demographics, Physicians Global Assessment (PGA) of disease activity 6 months prior to pregnancy and in all three trimesters of pregnancy and pregnancy outcomes were recorded.
Results
In 609 pregnancies, we observed 603 (99.0%) live births. Disease activity in one or more trimesters was seen in 283 women (46.5%). UC phenotype was associated with an increase in risk of disease activity (adjusted OR = 2.6 [1.8–3.9]; p < 0.001). Disease activity within 6 months prior to conceiving (169 women [27.7%]) was associated with an increased risk of continuous disease activity during pregnancy (adjusted OR of 5.3 [3.5–8.2]; p < 0.001). Disease activity during a previous pregnancy was associated with an increased risk of flares in subsequent pregnancies (adjusted OR of 3.2 [1.5–6.6]; p = 0.002). Sustained clinical remission throughout pregnancy was associated with an increased probability of normal birth term, birthweight and low risk of fetal growth restriction (FGR) and stillbirth.
Conclusion
Predictors for disease activity include disease activity in a previous pregnancy and/or prior to conception, as well as UC phenotype. Reassuringly, women with IBD in remission are not at increased risk of adverse pregnancy outcomes.
Odds ratio of alternating disease courses in subsequent pregnancies, UC and CD combined. Odds ratio of experiencing disease activity during pregnancy depending on occurrence of disease activity within 6 months of conception and attainment of remission at time of conception. Odds ratio of experiencing disease activity during pregnancy depending on IBD subtype.</description><subject>Birth weight</subject><subject>Cohort analysis</subject><subject>Cohort Studies</subject><subject>Denmark - epidemiology</subject><subject>disease activity</subject><subject>Female</subject><subject>Fetuses</subject><subject>Humans</subject><subject>IBD</subject><subject>Inflammatory bowel disease</subject><subject>Inflammatory bowel diseases</subject><subject>Inflammatory Bowel Diseases - diagnosis</subject><subject>Inflammatory Bowel Diseases - epidemiology</subject><subject>Intestine</subject><subject>Medical records</subject><subject>Phenotypes</subject><subject>Pregnancy</subject><subject>Pregnancy Complications - diagnosis</subject><subject>Pregnancy Complications - epidemiology</subject><subject>Pregnancy Outcome</subject><subject>Remission</subject><subject>Remission (Medicine)</subject><subject>Risk assessment</subject><subject>risk factors</subject><subject>Stillbirth</subject><subject>Womens health</subject><issn>0269-2813</issn><issn>1365-2036</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>EIF</sourceid><recordid>eNp10ctKxDAYBeAgio6jC19AAm50USdJmzZdDuMVBF3ouqS5OJG2qUnr0J0P4RP6JGas40Iwi4TAl0P4DwBHGJ3jsGa87c5xFidsC0xwnNKIoDjdBhNE0jwiDMd7YN_7F4RQmiGyC_aCwUlOswloH5ySRnTWeWg1lMYr7hXkojNvphug7J1pnmHr1HPDGzFA08CVrVXYTbcMN13xuubh_QBLu1LVJuLz_YPDC94Yv4TCLq3roO96ORyAHc0rrw5_zil4urp8XNxEd_fXt4v5XSRixlgkGEk0J1LkEjEtSiIQ5pRpRmOJeaZVijElWlONMA4sK5EkiAtBc5nEGYqn4HTMbZ197ZXvitp4oaqKN8r2viAZTShKGMkDPflDX2zvmvC7oNLAwjjXgWejEs5675QuWmdq7oYCo2JdQxFqKL5rCPb4J7EvayV_5WbuAcxGsDKVGv5PKuYPj2PkFyAqk-M</recordid><startdate>202302</startdate><enddate>202302</enddate><creator>Vestergaard, Thea</creator><creator>Julsgaard, Mette</creator><creator>Røsok, Julie F.</creator><creator>Vestergaard, Søren V.</creator><creator>Helmig, Rikke B.</creator><creator>Friedman, Sonia</creator><creator>Kelsen, Jens</creator><general>Wiley Subscription Services, Inc</general><scope>24P</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TK</scope><scope>7U9</scope><scope>H94</scope><scope>M7N</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-5373-8661</orcidid><orcidid>https://orcid.org/0000-0003-3070-8950</orcidid></search><sort><creationdate>202302</creationdate><title>Predictors of disease activity during pregnancy in women with inflammatory bowel disease—a Danish cohort study</title><author>Vestergaard, Thea ; Julsgaard, Mette ; Røsok, Julie F. ; Vestergaard, Søren V. ; Helmig, Rikke B. ; Friedman, Sonia ; Kelsen, Jens</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3888-c824fa2dc9d08fcb2c01a58f853d1a7fe61152ff5f0112dc7b0d20acc59d43703</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Birth weight</topic><topic>Cohort analysis</topic><topic>Cohort Studies</topic><topic>Denmark - epidemiology</topic><topic>disease activity</topic><topic>Female</topic><topic>Fetuses</topic><topic>Humans</topic><topic>IBD</topic><topic>Inflammatory bowel disease</topic><topic>Inflammatory bowel diseases</topic><topic>Inflammatory Bowel Diseases - diagnosis</topic><topic>Inflammatory Bowel Diseases - epidemiology</topic><topic>Intestine</topic><topic>Medical records</topic><topic>Phenotypes</topic><topic>Pregnancy</topic><topic>Pregnancy Complications - diagnosis</topic><topic>Pregnancy Complications - epidemiology</topic><topic>Pregnancy Outcome</topic><topic>Remission</topic><topic>Remission (Medicine)</topic><topic>Risk assessment</topic><topic>risk factors</topic><topic>Stillbirth</topic><topic>Womens health</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Vestergaard, Thea</creatorcontrib><creatorcontrib>Julsgaard, Mette</creatorcontrib><creatorcontrib>Røsok, Julie F.</creatorcontrib><creatorcontrib>Vestergaard, Søren V.</creatorcontrib><creatorcontrib>Helmig, Rikke B.</creatorcontrib><creatorcontrib>Friedman, Sonia</creatorcontrib><creatorcontrib>Kelsen, Jens</creatorcontrib><collection>Wiley-Blackwell Open Access Collection</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>MEDLINE - Academic</collection><jtitle>Alimentary pharmacology & therapeutics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Vestergaard, Thea</au><au>Julsgaard, Mette</au><au>Røsok, Julie F.</au><au>Vestergaard, Søren V.</au><au>Helmig, Rikke B.</au><au>Friedman, Sonia</au><au>Kelsen, Jens</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Predictors of disease activity during pregnancy in women with inflammatory bowel disease—a Danish cohort study</atitle><jtitle>Alimentary pharmacology & therapeutics</jtitle><addtitle>Aliment Pharmacol Ther</addtitle><date>2023-02</date><risdate>2023</risdate><volume>57</volume><issue>3</issue><spage>335</spage><epage>344</epage><pages>335-344</pages><issn>0269-2813</issn><eissn>1365-2036</eissn><abstract>Summary
Background and Aims
Inflammatory bowel disease (IBD) activity during pregnancy is associated with adverse pregnancy outcomes. We aimed to identify key clinical characteristics that predict disease activity during pregnancy.
Methods
Between January 2008 through 2021, we identified all singleton pregnancies among women with IBD recorded in patient and birth registries at a tertiary IBD centre in Denmark. Maternal and infant data were retrieved from medical records. Demographics, Physicians Global Assessment (PGA) of disease activity 6 months prior to pregnancy and in all three trimesters of pregnancy and pregnancy outcomes were recorded.
Results
In 609 pregnancies, we observed 603 (99.0%) live births. Disease activity in one or more trimesters was seen in 283 women (46.5%). UC phenotype was associated with an increase in risk of disease activity (adjusted OR = 2.6 [1.8–3.9]; p < 0.001). Disease activity within 6 months prior to conceiving (169 women [27.7%]) was associated with an increased risk of continuous disease activity during pregnancy (adjusted OR of 5.3 [3.5–8.2]; p < 0.001). Disease activity during a previous pregnancy was associated with an increased risk of flares in subsequent pregnancies (adjusted OR of 3.2 [1.5–6.6]; p = 0.002). Sustained clinical remission throughout pregnancy was associated with an increased probability of normal birth term, birthweight and low risk of fetal growth restriction (FGR) and stillbirth.
Conclusion
Predictors for disease activity include disease activity in a previous pregnancy and/or prior to conception, as well as UC phenotype. Reassuringly, women with IBD in remission are not at increased risk of adverse pregnancy outcomes.
Odds ratio of alternating disease courses in subsequent pregnancies, UC and CD combined. Odds ratio of experiencing disease activity during pregnancy depending on occurrence of disease activity within 6 months of conception and attainment of remission at time of conception. Odds ratio of experiencing disease activity during pregnancy depending on IBD subtype.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>36514957</pmid><doi>10.1111/apt.17348</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-5373-8661</orcidid><orcidid>https://orcid.org/0000-0003-3070-8950</orcidid><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Wiley Online Library Free Content; Wiley Online Library Journals; EZB Electronic Journals Library |
| subjects | Birth weight Cohort analysis Cohort Studies Denmark - epidemiology disease activity Female Fetuses Humans IBD Inflammatory bowel disease Inflammatory bowel diseases Inflammatory Bowel Diseases - diagnosis Inflammatory Bowel Diseases - epidemiology Intestine Medical records Phenotypes Pregnancy Pregnancy Complications - diagnosis Pregnancy Complications - epidemiology Pregnancy Outcome Remission Remission (Medicine) Risk assessment risk factors Stillbirth Womens health |
| title | Predictors of disease activity during pregnancy in women with inflammatory bowel disease—a Danish cohort study |
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