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Post-neonatal Outcomes of Infants Born to Women with Active Trimester One Inflammatory Bowel Disease: A Pilot Study
Richard Y Wu1, Parul Tandon1,2, Lindsy Ambrosio3
1Department of Medicine, University of Toronto, Toronto, Canada.
Insights
Active inflammatory bowel disease (IBD) during early pregnancy is linked to poorer infant growth. Controlling IBD in the first trimester is crucial for optimal infant development and outcomes.
Area of Science:
- Gastroenterology
- Obstetrics
- Pediatrics
Background:
- Inflammatory bowel diseases (IBD), including ulcerative colitis (UC) and Crohn's disease (CD), impact women of childbearing age.
- While early pregnancy IBD flares affect maternal and perinatal outcomes, infant post-neonatal impacts remain less understood.
Purpose of the Study:
- To investigate the association between active IBD disease activity during pregnancy and adverse post-neonatal infant outcomes.
- To assess the long-term effects of maternal IBD on infant growth and health within the first year of life.
Main Methods:
- A single-center cohort study monitored post-neonatal outcomes in infants born to mothers with IBD.
- Infant data, including growth parameters, feeding, and comorbidities, were collected via questionnaires up to one year postpartum.
Main Results:
- Maternal IBD activity in the first trimester correlated with adverse obstetrical outcomes, such as emergency C-sections and lower APGAR scores.
- Infants born to mothers with first-trimester IBD flares exhibited reduced weight-for-age and length-for-age Z-scores up to six months postpartum.
Conclusions:
- Active maternal IBD during the first trimester is associated with adverse post-neonatal outcomes, specifically impaired infant growth.
- Effective IBD management and disease control during early pregnancy are essential for promoting healthy infant development and improving 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.
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