Pregnancy and perinatal outcomes of mothers with inflammatory bowel disease in Taiwan: A national database analysis

Pregnant women with inflammatory bowel disease frequently experience suboptimal perinatal outcomes. One Taiwanese study conducted from 2001 to 2003 revealed higher risks of preterm birth and low birth weight in infants born to mothers with ulcerative colitis. With the advancement in disease management, we aim to investigate the pregnancy and perinatal outcomes of Taiwanese mothers with inflammatory bowel disease between 2004 and 2018.

We integrated data from Taiwan's Maternal and Child Health Database, Birth Reporting Database, National Health Insurance Database, and Catastrophic Illness Registry from 2004 to 2018. Mothers with inflammatory bowel disease were identified using International Classification of Diseases codes and the Catastrophic Illness Registry and matched 1:10 with healthy pregnant women based on the year of childbirth and maternal age. Statistical analyses involved chi-squared tests and conditional logistic regression models.

A total of 3,059,647 births were recorded, of which 146 were born to mothers with IBD (126 to those with ulcerative colitis and 20 to those with Crohn's disease). We observed no significant differences in stillbirths, preterm births, cesarean deliveries, low birth weights, small- or large-for-gestational-age newborns, or Apgar scores between the mothers with inflammatory bowel disease and the controls. Hypertensive disorders of pregnancy were less prevalent in the inflammatory bowel disease group (4.1% vs 13.6%; P = 0.001). Subgroup analysis revealed consistent outcomes in both ulcerative colitis and Crohn's disease, across socioeconomic status, and disease duration.

Pregnancy and perinatal outcomes are comparable in Taiwanese women with inflammatory bowel disease and matched healthy counterparts. While no statistically significant differences were observed, the limited statistical power for certain outcomes warrants cautious interpretation. These findings highlight the need for further investigation in larger cohorts or pooled datasets to explore small but potentially clinically meaningful differences.