PD-004 Reassuring Results on Long-term Health Outcomes in Children Born by Mothers with Inflammatory Bowel Disease—A Nationwide Cohort Study

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Abstract

Background:

A pregnancy complicated with maternal inflammatory bowel disease (IBD) is associated with increased risk of short-term adverse birth outcomes, e.g., low birthweight, preterm birth and caesarean section. It has previously been suggested that maternal IBD affects both the offspring's immediate and long-term morbidity, specifically congenital anomalies and neurodevelopmental problems have been described. In current study, we examined the impact of maternal IBD on the long-term risk of disease in the offspring during childhood and adolescence compared to children born by women without IBD.

Methods:

This nationwide cohort study was based on the Danish health registries including all children born alive in Denmark between 1989 and 2013. We assessed the association between maternal IBD and diagnosed diseases in the offspring according to 10 selected categories of physical and mental diseases (diabetes, thyroid disease, rheumatoid arthritis, IBD, epilepsy, chronic lung disease/asthma, mood affective disorders, schizophrenia/other paranoid psychoses, nervous conditions and congenital malformations). The time span from birth until diagnosis, or end of follow-up, was described and we computed the hazard ratios for child disease using Cox proportional hazard regression and logistic regression for the relative risk of congenital malformations diagnosed within the first year of life. The statistical models were adjusted for the following covariates; gender, year of birth, maternal age, mode of delivery, multiple birth, birth order, preterm birth, BMI and comorbidity. Stratification on IBD subtype; Crohn´s disease and ulcerative colitis, was carried out in a sub analysis.

Results:

The exposed cohort comprised 9238 children born by women with IBD, and the unexposed cohort of 1,371,407 children born by women without IBD followed from date of birth. The unexposed cohort was followed for a median time of 13.8 years and the exposed cohort for a median time of 9.7 years. In both groups the maximum time of follow-up was 25.9 years. We found that children born by mothers with IBD had an almost 6 times increased risk of being diagnosed with IBD compared with children born by mothers without IBD adjusted HR (95% CI): 5.67 (4.63–6.96). Apart from this partially expected finding, children born by mothers with IBD were not more likely to be diagnosed with any of the other included diagnoses. The risk estimates for all other childhood disease categories were close to unity, and we did not find significantly increased risk for any of the other diseases. When stratifying for IBD subtypes the risk of IBD was even more pronounced in the Crohn´s disease group; adjusted HR (95% CI): 7.59 (5.65–10.19), than in the ulcerative colitis group.

Conclusions:

From this huge study on long-term health consequences in children born by mothers with IBD the association showed an expected increased risk of IBD in the offspring. We did not find evidence for an increased risk of any of the other examined diseases in the offspring. This finding is very reassuring for women with IBD regarding the long-term reproductive outcomes in their offspring.

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