Pregnancy outcomes in women with inflammatory bowel disease who successfully conceived via assisted reproduction techniq
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MATERNAL-FETAL MEDICINE
Pregnancy outcomes in women with inflammatory bowel disease who successfully conceived via assisted reproduction technique Inbar Lavie1 · Michael Lavie1,2 · Reut Doyev1,2 · Yuval Fouks1,2 · Foad Azem1,2 · Yariv Yogev1,2 Received: 9 May 2020 / Accepted: 8 June 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Objective Women with inflammatory bowel disease (IBD) have an increased risk for adverse pregnancy outcome, so as women using assisted reproduction technology (ART). However, data are scarce regarding the risk imposed by the combination of both. Thus, we aimed to assess pregnancy outcome in these women. Methods A retrospective case–control study, of women with IBD who conceived using ART due to female infertility. The study group (IBD-ART) was matched using propensity score and compared in a 1:1 ratio with three control groups, IBD patients who conceived spontaneously (IBD-SP), women using ART (H-ART) and women who conceived spontaneously (H-SP). Results The study group comprised of 49 women with IBD conceived via ART that gave birth at our center during the study period. All studied groups did not differ in demographics and obstetric characteristics. IBD groups (both ART and spontaneous) were comparable in disease status prior and throughout pregnancy. Maternal outcome showed no difference regarding preterm birth and pregnancy complications among all studied groups. Women in the IBD-ART group had decreased rates of vaginal delivery (34.7% vs 57.1%, p = 0.032) and higher rates of elective CS (32.7% vs 14.3%, p = 0.048) in comparison to H-SP group, but comparable rates to both IBD-SP and H-ART groups. Neonatal outcomes were comparable among all studied groups. In a sub-analysis by disease type, a higher rate of gestational diabetes was found among ulcerative colitis patients using ART (29.4% Crohn’s vs 6.1% UC, p = 0.025). Conclusion Patients with IBD undergoing ART have comparable pregnancy outcome to women using ART and to patients with IBD with spontaneous pregnancy. Keywords Crohn’s disease · Ulcerative colitis · Inflammatory bowel disease · Assisted reproduction technology · Fertility · Adverse birth outcomes
Introduction Inflammatory bowel disease (IBD) is a group of a chronic intestinal inflammation with a relapsing and remitting course. Crohn’s disease (CD) and ulcerative colitis (UC) are the principal types of inflammatory bowel disease. These Inbar Lavie and Michael Lavie contributed equally to this manuscript. * Michael Lavie [email protected] 1
Sackler Faculty of Medicine, Tel-Aviv University, Tel‑Aviv, Israel
Lis Hospital for Women, Tel-Aviv Sourasky Medical Center, Weizman 6 St, Tel‑Aviv, Israel
2
conditions affect women of childbearing age [1], making both fertility and pregnancy outcome a significant concern [2, 3]. Infertility seems to be increased among patients with IBD [4, 5] and may be associated with active inflammation, pelvic dysfunction, reduced ovarian reserve or history of surgical procedures [3]. Moreover, pregna
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