Maternal Outcomes and Pregnancy-Related Complications Among Hospitalized Women with Inflammatory Bowel Disease: Report from the National Inpatient Sample

Daniela Guerrero Vinsard; Raffi Karagozian; Dorothy B Wakefield; Sunanda V Kane

doi:10.1007/s10620-021-07210-z

Maternal Outcomes and Pregnancy-Related Complications Among Hospitalized Women with Inflammatory Bowel Disease: Report from the National Inpatient Sample

Dig Dis Sci. 2022 Sep;67(9):4295-4302. doi: 10.1007/s10620-021-07210-z. Epub 2021 Aug 18.

Authors

Daniela Guerrero Vinsard¹, Raffi Karagozian², Dorothy B Wakefield³, Sunanda V Kane⁴

Affiliations

¹ Department of Gastroenterology and Hepatology, Mayo Clinic, 200 1ST St SW, Rochester, MN, 55905, USA. guerrero.daniela@mayo.edu.
² Department of Gastroenterology and Hepatology, Tufts Medical Center, Boston, MA, USA.
³ Department of Epidemiology, Saint Francis Hospital, Hartford, CT, USA.
⁴ Department of Gastroenterology and Hepatology, Mayo Clinic, 200 1ST St SW, Rochester, MN, 55905, USA.

PMID: 34406586
DOI: 10.1007/s10620-021-07210-z

Abstract

Background and aims: Previous studies have been inconsistent in reporting the risk of pregnancy-related complications in women with IBD. We aimed to investigate the differences in frequencies of pregnancy-related complications requiring hospitalization in women with IBD compared to women without IBD.

Methods: We performed a population-based, cross-sectional study using the 2014 USA National Inpatient Sample. Frequencies of ICD-9 codes for pregnancy-related complications in women aged 18-35 years with IBD were compared to women with no IBD controlling for confounders predisposing to pregnancy complications. Adjusted odds ratios were calculated for each outcome.

Results: A total of 6705 women with IBD and a pregnancy complication were discharged from the hospital in 2014. In multivariate analyses, there was no statistically significant difference between women with and without IBD for: spontaneous abortion, post-abortion complications, ectopic pregnancy, hemorrhage, severe preeclampsia, eclampsia, early labor, polyhydramnios, hyperemesis, missed abortion, mental disorder during pregnancy, and forceps delivery. Women with IBD had significant lower odds for prolonged pregnancy, gestational diabetes, fetal distress, umbilical cord complications, obstetric trauma, mild preeclampsia, and hypertension. There was, however, higher odds for infectious and parasitic complications (OR 1.74, 95% CI 1.42-2.14, p < 0.0001), UTIs (OR 1.65, 95% CI 1.07-2.60, p = 0.02), and anemia (OR 5.26, 95% CI 4.01-6.90, p < 0.0001).

Conclusions: In this large population-based analysis, women with IBD had higher odds for certain infections such as UTIs and anemia during pregnancy when compared to women with no IBD. For other pregnancy-related complications, women with IBD had the same or lower odds than women with no IBD. These data are important to share with women with IBD considering pregnancy.

Keywords: Anemia; Infections; Inflammatory bowel disease; Maternal outcomes; Pregnancy.

MeSH terms

Abortion, Spontaneous*
Cross-Sectional Studies
Female
Hospitalization
Humans
Inflammatory Bowel Diseases* / complications
Inflammatory Bowel Diseases* / epidemiology
Inpatients
Pre-Eclampsia*
Pregnancy
Pregnancy Complications* / epidemiology
Pregnancy Outcome