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Crohn's disease as a risk factor for the outcome of pregnancy
1Department of Obstetrics and Gynecology, Geneva University Hospital, Geneva, Switzerland. michel.a.morales@hcuge.ch
Background/Aims:
To study the effects of Crohn's disease on the course of pregnancy and the influence of pregnancy on the activity of Crohn's disease.
Methodology:
The course of 35 pregnancies in 23 women with Crohn's disease were reviewed over a 12 years period.
Results:
Nine pregnancies (25%) started when Crohn's disease was active. We observed 2 exacerbations among the 9 pregnancies with active disease and 7 exacerbations among the 26 pregnancies with quiescent disease: this represents a total exacerbation rate of 26% similar to non-pregnant women with Crohn's disease. The course of pregnancy was normal with a full-term delivery in 22 cases (63%). We observed 5 premature deliveries (14%), 5 spontaneous abortions (14%), 1 induced abortion (3%) and 2 liveborns with severe malformations (6%). Preterm delivery was significantly associated with reactivation of Crohn's disease during pregnancy (P = 0.009), whereas fetal loss was significantly associated with activity of Crohn's disease at the time of conception (P = 0.015).
Conclusions:
Pregnancy does not appear to influence the course of Crohn's disease. The relapse rate of Crohn's disease during pregnancy is similar to that of the general Crohn's disease population. Active Crohn's disease at the time of conception or reactivation during pregnancy are risk factors for abnormal pregnancy outcome.