Pregnancy Outcomes and Disease Activity in Women With Inflammatory Bowel Disease in Qatar: A Retrospective Cohort...

Inflammatory bowel disease (IBD) commonly affects women of childbearing age and may complicate pregnancy. This study evaluated disease activity, treatment patterns, and pregnancy outcomes among women with IBD in Qatar.

Retrospective cohort study at a multidisciplinary Obstetric-IBD clinic in Doha including 97 pregnant women with confirmed IBD (November 2019-October 2023). Demographics, IBD characteristics, medication use, disease activity (CDAI for Crohn's, Mayo score for ulcerative colitis), and pregnancy outcomes were retrieved from electronic records. Associations were analyzed using chi-square, Fisher's exact tests, and logistic regression, with significance set at p < 0.05.

Of 97 women, 56.7% had ulcerative colitis (UC) and 43.3% Crohn's disease (CD). Pregnancy outcomes did not differ significantly between UC and CD (p = 0.216). Most (88.1%) remained in remission during pregnancy, decreasing to 81.7% postpartum. Biologic therapy was used in 33%. Full-term delivery occurred in 82.6%, with 13% preterm births and 4.4% abortions; Cesarean section rate was 46.7%. Women who received therapy during pregnancy had significantly better outcomes than those who were untreated (OR = 3.4, p = 0.028). Treatment during pregnancy remained protective across trimesters, with monotherapy (OR 4.1-4.8, p < 0.05) and combination therapy (OR 4.4-6.3, p < 0.05) showing consistent benefit.

Remission and continuation of therapy during pregnancy were strongly associated with favorable outcomes. These results emphasize that maintaining remission and adhering to therapy both contribute independently to improved maternal and neonatal outcomes. The findings support the safety of continuing therapy and highlight the need for multidisciplinary care to optimize health outcomes.