Pregnancy and Inflammatory Bowel Disease: impact of gestation in a case series.

Abstract

Introduction and objectives: Pregnancy is a relevant milestone in the clinical course of a patient with Inflammatory Bowel Disease (IBD). The objective was to evaluate the impact of adherence to the therapeutic plan in the course of pregnancy and to analyze variables related to disease activity, treatments received and pregnancy outcome.

Material and methods: single-center retrospective observational study in pregnant patients with IBD. Demographic variables related to the disease, treatment received and pregnancy outcomes were collected. Adherent group was defined as the group that agreed to the therapeutic plan. A non-adherent group was defined as those patients who did not agree to the therapeutic plan or who abandoned it during pregnancy.

Results: 32 patients were included, 56.3% diagnosed with Crohn's disease (CD) and 43.7% with Ulcerative Colitis (UC). Of those diagnosed with CD, 13 were in remission and 5 had moderate activity, compared to 11 in remission and 3 with mild activity in UC. Eleven (34.4%) patients abandoned treatment without consensus, and 12 (37.5%) patients had flares during pregnancy. Significant differences were found with respect to the number of flares and fetal birth weight. Differences were also found when comparing inflammatory activity at the beginning of pregnancy and the evolution of pregnancy.

Conclusion:The study data reinforce the importance of preconception counseling, activity control and adherence to the therapeutic plan, motivating us to improve the care and follow-up of our patients of gestational age.

Keywords: pregnancy, inflammatory bowel disease, preconception counseling.