Background: During pregnancy it is difficult to reliably monitor inflammatory bowel disease (IBD) activity. Common biomarkers as C-reactive protein (CRP) and fecal calprotectin (FC) were shown to increase throughout normal pregnancy. Fecal lactoferrin (FL) has been shown to be a reliable biomarker for IBD activity. The stability of FL has never been examined during pregnancy. The aim of the study was to compare FL levels during different stages of pregnancy
Methods: 83 stool samples were collected for FL analysis during years 2014–2015 at Shaare-Zedek Medical Center. All patients were one of four groups; 44 (53%) were pregnant with IBD, 12 (15%) pregnant without IBD, 16 (19%) with IBD but not pregnant and 11 (13%) were healthy not pregnant women. The results were compared with other IBD biomarkers and during various stages of pregnancy.
Results: Median FL (μg/mL) for pregnant women was similar to non-pregnant women (7 vs. 6, respectively, p=0.61). Median FL was higher in IBD compared to non IBD patients (9.5 vs. 2, respectively, p=0.035). Comparing the four groups showed median FL levels were 8, 17.5, 2 and 2 for IBD-pregnant, IBD-non pregnant, pregnant-non IBD and non pregnant-non IBD patients, respectively. In trimesters one, two and three median FL levels were 12, 8 and 7, respectively, p=0.18). FL correlated positively with FC (Pearson correlation <0.001), but did not correlate with CRP, hemoglobin or erythrocyte sedimentation rate.
Conclusions: FL is steady throughout pregnancy. IBD patients had higher FL than healthy patients. This test may be used as the ideal biomarker to reliably monitor disease activity of pregnant patients with IBD