Maternal and fetal outcomes in patients with Crohn's disease: a population-based cohort study

Crohn's disease, which typically affects individuals of reproductive age, has risen in prevalence over the past decades. The study objective was to determine the impact of maternal Crohn's disease on maternal and neonatal adverse outcomes.

A retrospective cohort study was performed using the Healthcare Cost and Utilization Project-National Inpatient Sample from the United States. International Classification of Diseases, 10th edition (ICD-10) codes were used to identify individuals who delivered between 2016 and 2021, and then those with Crohn's disease were identified (ICD-10 code K50). The effect of Crohn's disease on pregnancy was estimated using multivariable logistic regression adjusted for baseline maternal characteristics.

There were 4,337,612 births between 2016 and 2021, of which 5,671 were associated with maternal Crohn's disease, for an overall period prevalence of 13.1/10,000 births. There was an upward trend in prevalence from 10.2/10,000 deliveries in 2016 to 15.6/10,000 deliveries in 2021 (p<0.0001). Individuals with Crohn's disease were at increased risk of preeclampsia (odds ratio 1.6, 95 % CI 1.4-1.7), chorioamnionitis (1.3, 1.1-1.5), placental abruption (1.4, 1.1-1.7), instrumental delivery (1.3, 1.1-1.4), cesarean delivery (1.6, 1.5-1.7), postpartum hemorrhage (1.3, 1.2-1.5), sepsis (2.0, 1.5-2.7), and venous thromboembolic events (2.1, 1.1-3.8). Neonates born to these mothers were more likely to be premature (1.6, 1.5-1.7), suffer from congenital anomalies (1.5, 1.2-1.8) and intrauterine growth restriction (1.7, 1.5-1.9).

Crohn's disease in pregnancy was associated with adverse maternal and neonatal outcomes. Pregnant patients with Crohn's disease should therefore be closely monitored throughout their pregnancy to minimize these adverse outcomes.