Background: Inflammatory bowel disease (IBD-Crohn's disease [CD], ulcerative colitis [UC]) has been associated with increased risk of adverse birth outcome. Limited data are available on the postnatal development in children from IBD mothers. Our aim was to evaluate the effect of disease activity and medical therapy on pregnancy and birth outcome and to compare the prevalence of preterm birth, congenital malformations and postnatal development between children from IBD vs. healthy mothers.
Methods: Data on medical therapy at conception and during pregnancy, data on pregnancy, delivery and newborn complications were assessed retrospectively. Data on postnatal development were retrospectively collected and physical condition of each child was evaluated by a pediatrician. Children from healthy mothers composed the control group. Body composition analysis was performed in every child.
Results: Fifty-six pregnancies of 36 women diagnosed with IBD were studied. Active disease was detected in 8 pregnancies during the first, in 5 cases during the second and 6 cases during the third trimester. IBD-related medication was used at conception in 39 cases. Pregnancy complications occurred in 13 cases. Newborn complications were significantly more common in case of active disease in the 3rd trimester (p=0.033 and p=0.029 in CD and UC) and in case of steroid use in the 3rd trimester (p=0.031). Thirty-six children born to IBD mothers and 16 age-matched healthy controls have been included in the second part of the study. Considering children from IBD mothers, congenital malformations developed in 5 newborns, low birth weight in 4 infants, infectious complication in 7 infants. In control group, none of these occurred. Considering postnatal development, 6 children of IBD mothers developed chronic disease. IBD occurred in one child. The mean growth percentile was 65.6%, and the mean weight percentile was 64.2%. Mean InBody score was 87.6 points (max: 100 points). In control children, 1 suffered from mitral prolapsed, 1 developed asthma. Mean growth percentile was 71%, and the mean weight percentile was 66%. Mean InBody score was 88.1 points. Statistically no difference was found between children with IBD mother vs. controls regarding to growth patterns, gestational ages, newborn complications, frequency of infectious and chronic diseases, food allergies and InBody scores.
Conclusions: Our results revealed complications in 23% of the IBD pregnancies. Disease activity and steroid use during the 3rd trimester proved to be predictive to newborn complications. Considering postnatal development, no difference was seen between children born to IBD mothers compared to controls despite the higher number of newborn complications.