Journal Article

Congenital abnormalities and other birth outcomes in children born to women with ulcerative colitis in Denmark and Sweden

Larsson, Heidi, Granath, Fredrik, Nφrgaard, Mette, Ekbom, Anders, Sφrensen, Henrik Toft, Pedersen, Lars, Ludvigsson, Jonas F., Falconer, Henrik, Stephansson, Olof, Kieler, Helle

2011

Overview

BackgroundStudies of women with ulcerative colitis (UC) during pregnancy have reported increased risks of preterm delivery, growth restriction, and congenital malformation. However, the results are inconsistent due to inadequate study design and limitations in sample size.MethodsWe performed a population-based prevalence study on 2637 primiparous women with a UC hospital diagnosis prior to delivery and 868,942 primiparous women with no UC diagnosis in Denmark and Sweden, 1994–2006. Logistic regression analysis was used to estimate relative risks for moderately (32–36 weeks) and very (before 32 weeks) preterm birth, 5-minute Apgar score <7, small-for-gestational-age (SGA) birth, stillbirth, neonatal death, and congenital abnormalities.ResultsMaternal UC was associated with increased risk of moderately preterm birth (prevalence odds ratio [POR] 1.77, 95% confidence interval [CI]: 1.54–2.05), very preterm birth (POR 1.41, 95% CI: 1.02–1.96), cesarean section (POR 2.01, 95% CI: 1.84–2.19), and neonatal death (POR 1.93, 95% CI: 1.04–3.60). The strongest associations were observed for prelabor cesarean section (POR = 2.78, 95% CI: 2.38–3.25) and induced preterm delivery (POR 2.55, 95% CI: 1.95–3.33). There was a slightly increased risk of SGA birth (POR 1.27, 95% CI: 1.05–1.54). We found no association between UC and overall risk of congenital abnormalities (POR 1.05, 95% CI: 0.84–1.31) or specific congenital abnormalities. Risks for adverse birth outcomes were higher in women with previous UC-related surgery and hospital admissions.ConclusionsWomen with UC have increased risks of preterm delivery, SGA-birth, neonatal death, and cesarean section but not congenital abnormalities. Adverse birth outcomes appeared correlated with UC disease severity. (Inflamm Bowel Dis 2011;)

• Publisher: Oxford University Press,Wiley Subscription Services, Inc., A Wiley Company
• Subject: Abnormalities, Multiple - etiology / Adult / Birth / birth outcomes / Cesarean section / Children / Cohort Studies / Colitis, Ulcerative - complications / Colitis, Ulcerative - diagnosis / Colitis, Ulcerative - drug therapy / congenital abnormalities / Congenital Abnormalities - etiology / Congenital defects / Denmark - epidemiology / Female / Follow-Up Studies / growth restriction / Hospitals / Humans / Infant, Newborn / Infant, Premature / Inflammatory bowel disease / Inflammatory bowel diseases / Intestine / Maternal Age / Neonates / Parity / Population Surveillance / Pregnancy / Pregnancy Complications - diagnosis / Pregnancy Outcome / Premature Birth / Prevalence / Prognosis / Regression analysis / Risk assessment / Surgery / Sweden - epidemiology / Ulcerative colitis / Young Adult