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Published on: November 20, 2015
Crohn's disease is a risk factor for preterm birth
Olof Stephansson1, Heidi Larsson, Lars Pedersen
1Clinical Epidemiology Unit and Centre for Pharmacoepidemiology, Department of Medicine, Karolinska University Hospital and Institutet, Stockholm, Sweden. olof.stephansson@ki.se
Summary
Pregnancy in women with Crohn's disease (CD) increases the risk of preterm birth and cesarean sections. However, CD does not appear to raise the risk for birth defects or other adverse pregnancy outcomes.
Area of Science:
- Reproductive Medicine
- Gastroenterology
- Public Health
Background:
- Crohn's disease (CD) in pregnant women is associated with increased risks for adverse pregnancy outcomes.
- Previous studies on this topic were limited by small sample sizes.
Purpose of the Study:
- To examine pregnancy outcomes in a large cohort of primiparous women with Crohn's disease.
Main Methods:
- A population-based prevalence study using Swedish and Danish medical birth registries (1994-2006).
- Linked birth registry data with national patient registries to identify 2377 women with CD and 869,202 controls.
- Logistic regression analysis estimated risks for pre-eclampsia, preterm birth, low Apgar scores, cesarean section, small for gestational age (SGA), stillbirth, and congenital malformations.
Main Results:
- Maternal CD was associated with significantly increased risks for moderately and very preterm birth.
- Increased risk for cesarean section, particularly prelabor and induced preterm delivery, was observed.
- A slightly increased risk for small for gestational age (SGA) birth was noted, especially between 2002-2006.
- No increased risks were found for pre-eclampsia, low 5-minute Apgar scores, stillbirth, or congenital malformations.
Conclusions:
- Maternal Crohn's disease is a significant risk factor for preterm birth.
- Crohn's disease does not appear to be a risk factor for birth defects in offspring.
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