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Vol. 44. Issue 4.
Pages 277-285 (April 2021)
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Vol. 44. Issue 4.
Pages 277-285 (April 2021)
Original article
DOI: 10.1016/j.gastre.2020.08.004
Pregnancy in inflammatory bowel disease: Experience of a Chilean cohort
Embarazo en enfermedad inflamatoria intestinal: experiencia en una cohorte chilena
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Paulina Nuñez F.a, Rodrigo Querab,
Corresponding author
rquera@clc.cl

Corresponding author.
, Eduardo Sepúlvedac, Daniela Simiand, Gonzalo Pizarrob, Jaime Lubascherb, Lilian Floresb, Patricio Ibañezb, Carolina Figueroae, Udo Kronberge
a Universidad de Chile, Facultad de Medicina Occidente, Hospital San Juan de Dios, Universidad de Chile, Santiago, Chile
b Programa Enfermedad Inflamatoria Intestinal, Departamento Gastroenterología, Clínica Las Condes, Santiago, Chile
c Departamento de Ginecología y Obstetricia Universidad de Chile, Santiago, Chile
d Dirección Académica, Departamento Gastroenterología, Clínica Las Condes, Santiago, Chile
e Unidad de Coloproctología, Departamento de Cirugía, Clínica Las Condes, Santiago, Chile
Article information
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Table 1. Clinical and demographic characteristics of pregnant patients with IBD.
Table 2. Outcome of the pregnancy according to type of IBD.
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Abstract
Background

In inflammatory bowel disease (IBD) a high percentage of women are diagnosed during their reproductive age. IBD in remission is the ideal scenario when planning a pregnancy.

Aims

To describe the clinical characteristics of pregnancy/newborn and assess disease activity at the time of conception and throughout the pregnancy in patients with IBD treated at a tertiary centre in Chile.

Methods

We retrospectively reviewed women diagnosed with IBD who were pregnant or delivered between 2017 and 2020. Demographic, clinical, obstetric and delivery data were obtained from the IBD registry, approved by the local IRB. Descriptive statistics and association tests were performed (χ2, p ≤ 0.05).

Results

Sixty women with IBD were included. At the beginning of pregnancy, 21 (35%) had active disease and 39 (65%) were in remission. Of those with active disease, 16 (66%) remained active and 6 had spontaneous abortions. In those who were in remission, 26 (69%) remained in this condition. Nine patients (15%) discontinued treatment, and 6 of these had inflammatory activity during pregnancy. Preconception counselling was performed in 23 of the 60 patients, being higher in the group that remained in remission during pregnancy (65% vs. 35%, p = 0.02). Patients who had a flare during pregnancy had more probability of preterm birth (<37 weeks) and newborn with lower weight compared with the group that always remained in remission (89% vs 74%, p = 0.161) and (2.885 vs 3.370 g; p = 0.0014).

Conclusion

Remission presents better outcomes in pregnancy and preconception counselling would allow a better IBD control during pregnancy.

Keywords:
Pregnancy
Preconception counselling
Inflammatory bowel disease
Ulcerative colitis
Crohn’s disease
Resumen
Introducción

El diagnóstico de enfermedad inflamatoria intestinal (EII) se realiza, en un alto porcentaje, durante la edad reproductiva. La EII en remisión es el mejor escenario para planificar el embarazo.

Objetivos

Describir las características clínicas del embarazo y del recién nacido, evaluando la actividad de la enfermedad en el momento de la concepción y en la evolución del embarazo en un centro terciario en Chile.

Métodos

Estudio observacional, retrospectivo, incluyó a mujeres con EII que habían tenido un parto durante 2017–2020. Los datos demográficos, clínicos y obstétricos se obtuvieron del Registro de EII. Se realizó análisis estadístico descriptivo y de asociación (χ2, p ≤ 0,05).

Resultados

Se incluyeron 60 mujeres en el estudio. Al inicio del embarazo, 21 (35%) presentaban actividad inflamatoria y 39 (65%) estaban en remisión. Del grupo con actividad, 16 (66%) permanecieron activas y seis tuvieron un aborto espontáneo. Aquellas en remisión, 26 (69%) permanecieron en esta condición; nueve pacientes (15%) habían suspendido el tratamiento, seis de las cuales presentaron actividad durante el embarazo. El consejo preconcepcional fue realizado en 23/60 pacientes, siendo mayor en el grupo que permaneció en remisión durante el embarazo (65% vs. 35%, p = 0,02). Pacientes con brotes durante el embarazo tuvieron mayor probabilidad de embarazo pretérmino (<37 semanas) y recién nacido de menor peso comparado con el grupo que permaneció en remisión (89 vs. 74%; p = 0,161) y (2,885 vs. 3,370 g; p = 0,0014), respectivamente.

Conclusión

La remisión durante el embarazo presenta los mejores resultados y el consejo preconcepcional permite un mejor control de la EII durante el embarazo.

Palabras clave:
Embarazo
Consejo preconcepcional
Enfermedad inflamatoria intestinal
Colitis ulcerosa
Enfermedad de Crohn

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