Risk of adverse pregnancy and birth outcomes after open versus laparoscopic surgery for inflammatory bowel disease: a...

The aim of this nationwide population-based cohort study was to examine an association between previous open and laparoscopic abdominal surgery for inflammatory bowel disease (IBD) and adverse pregnancy and birth outcomes.

From the Danish Medical Birth Registry, we identified women with Crohn's disease (CD) and ulcerative colitis (UC) who had given birth between 1997 and 2024. We compared the risk of adverse pregnancy and birth outcomes between women with and without prior abdominal surgery using adjusted odds ratios (ORs) with 95% confidence intervals (CIs).

We identified 12 894 pregnancies among women with IBD (5201 CD, 7693 UC). In 2070 (16.1%) pregnancies, at least one abdominal operation had been performed prior to conception. In CD pregnancies, prior surgery was associated with an increased risk of elective cesarean section (adjusted OR [aOR] = 1.68, 95% CI: 1.43-1.97). In UC pregnancies, prior surgery was associated with an increased risk of prematurity (aOR = 2.92, 95% CI: 2.25-3.76), preterm elective and emergency cesarean section (aOR = 6.99, 95% CI: 3.46-13.9 and aOR = 3.46, 95% CI: 2.34-5.04), elective cesarean section (aOR = 11.2, 95% CI: 9.23-13.5), low birth weight (<2500 g: aOR = 1.99, 95% CI: 1.46-2.67), and neonatal intensive care (aOR = 4.10, 95% CI: 1.64-9.78). Laparoscopic surgery was not associated with fewer adverse pregnancy or birth outcomes compared to open surgery.

Prior surgery for IBD is associated with an increased risk of adverse pregnancy and birth outcomes. A laparoscopic approach does not mitigate these risks.