Therapeutic Drug Use in Women With Crohn's Disease and Birth Outcomes: A Danish Nationwide Cohort Study

Nørgård, Bente; Pedersen, Lars; Christensen, Lisbet A.; Sørensen, Henrik T.
July 2007
American Journal of Gastroenterology;Jul2007, Vol. 102 Issue 7, p1406
Academic Journal
BACKGROUND: Crohn's disease (CD) is associated with increased risk of adverse birth outcomes. However, existing studies have not taken into account the impact of drug treatment. We examined the impact of drug treatment on birth outcomes—low birth weight (LBW), preterm birth, LBW at term, and congenital abnormalities (CAs)—among CD women. METHODS: A nationwide Danish cohort study of 900 children born to CD women between 1996 and 2004, based on the National Registry of Patients, the Birth Registry, and the nationwide prescription database. Pregnancies were classified according to receipt of prescriptions for CD medication: no drugs (reference group), 5-aminosalicylic acid (5-ASA)/sulfasalazine, steroids, and azathioprine (AZA)/6-mercaptopurine (6-MP). We used logistic regression analyses to estimate the relative risk of birth outcomes with 95% confidence intervals. We used a proxy measure for disease activity. RESULTS: Preterm births were more prevalent among steroid- and AZA/6-MP-exposed women (12.3% and 25%, respectively) compared with the reference group (6.5%). CAs were more prevalent among AZA/6-MP-exposed compared with reference group (15.4% vs 5.7%). Among steroid exposed, the risk of preterm birth was 1.4 (95% CI 0.6–3.3). Among AZA/6-MP exposed, the risk of preterm birth and CAs was 4.2 (95% CI 1.4–12.5) and 2.9 (95% CI 0.9–8.9), respectively. CONCLUSIONS: The relative risk of adverse birth outcomes among CD women varied by type of drugs prescribed during pregnancy. The risk of preterm birth and CAs was greater when AZA/6-MP was prescribed, even after adjusting for confounders. However, further information is needed to determine whether the associations are causal.


Related Articles

  • Inflammatory Bowel Disease and Risk of Adverse Pregnancy Outcomes. Boyd, Heather A.; Basit, Saima; Harpsøe, Maria C.; Wohlfahrt, Jan; Jess, Tine // PLoS ONE;Jun2015, Vol. 10 Issue 6, p1 

    Background and Objectives: Existing data on pregnancy complications in inflammatory bowel disease (IBD) are inconsistent. To address these inconsistencies, we investigated potential associations between IBD, IBD-related medication use during pregnancy, and pregnancy loss, pre-eclampsia, preterm...

  • Frequency and Risk Factors for Extraintestinal Manifestations in the Swiss Inflammatory Bowel Disease Cohort. Vavricka, Stephan R.; Brun, Lionel; Ballabeni, Pierluigi; Pittet, Valérie; Vavricka, Bettina Mareike Prinz; Zeitz, Jonas; Rogler, Gerhard; Schoepfer, Alain M. // American Journal of Gastroenterology;Jan2011, Vol. 106 Issue 1, p110 

    OBJECTIVES:Data on the frequency of extraintestinal manifestations (EIMs) in Crohn's disease (CD) and ulcerative colitis (UC) and analyses of their risk factors are scarce. We evaluated their prevalence and risk factors in a large nationwide cohort of inflammatory bowel disease (IBD)...

  • Surgery in a Population-Based Cohort of Crohn's Disease From Olmsted County, Minnesota (1970-2004). Peyrin-Biroulet, Laurent; Harmsen, W Scott; Tremaine, William J; Zinsmeister, Alan R; Sandborn, William J; Loftus, Edward V // American Journal of Gastroenterology;Nov2012, Vol. 107 Issue 11, p1693 

    OBJECTIVES:We sought to estimate the need for surgery in an American population-based cohort of Crohn's disease.METHODS:The medical records of 310 incident cases of Crohn's disease from Olmsted County, Minnesota, diagnosed between 1970 and 2004, were reviewed through March 2009. Cumulative...

  • An intestinal arsonist: pathobiont ignites IBD and flees the scene. Jellbauer, Stefan; Raffatellu, Manuela // Gut;Jul2014, Vol. 63 Issue 7, p1034 

    The author discusses a study related to intestinal arsonist. It highlights evidence for proteobacteria for inflammatory bowel diseases (IBD) that has been sorted by cohort studies showing inflammatory diarrhoea caused by either Salmonella species or Campylobacter species. It further talks about...

  • Allopurinol use in pregnancy in three women with inflammatory bowel disease: safety and outcomes: a case series. Fazal, Muhammad W.; Doogue, Matt P.; Leong, Rupert W.; Bampton, Peter A.; Andrews, Jane M. // BMC Gastroenterology;2013, Vol. 13 Issue 1, p1 

    Background Allopurinol is a frequently prescribed drug. In inflammatory bowel disease patients who shunt thiopurine metabolism towards more toxic and less desirable pathways, allopurinol is proving to be an effective add on therapy with good resultant disease control and less treatment side...

  • A productive battle with Crohn's disease.  // Foods Matter (UK);Mar2009, p6 

    The author focuses on his wife's battle against Crohn's disease. He relates that his wife was diagnosed with the disease nine months after they got married in 2003. He states that the inflammation in her intestine resulted in fistulas in her bladder and spine which became infected, resulting in...

  • The London Position Statement of the World Congress of Gastroenterology on Biological Therapy for IBD With the European Crohn's and Colitis Organisation: Pregnancy and Pediatrics. Mahadevan, Uma; Cucchiara, Salvatore; Hyams, Jeffrey S.; Steinwurz, Flavio; Nuti, F.; Travis, Simon P. L.; Sandborn, William J.; Colombel, Jean-Frederio // American Journal of Gastroenterology;Feb2011, Vol. 106 Issue 2, p214 

    Women with inflammatory bowel disease (IBD) have similar rates of fertility to the general population, but have an increased rate of adverse pregnancy outcomes compared with the general population, which may be worsened by disease activity. Infertility is increased in those undergoing ileal...

  • WpÅ‚yw nieswoistych zapaleÅ„ jelit na rozrodczość. Jałocha, Irena; Gabryś, Marian Stanisław // Gastroenterologia Polska / Gastroenterology;2010, Vol. 17 Issue 5, p333 

    No abstract available.

  • Pregnancy outcome in patients with inflammatory bowel disease treated with thiopurines: cohort from the CESAME Study. Coelho, J.; Beaugerie, L.; Colombel, J. F. // Inflammatory Bowel Disease Monitor;2011, Vol. 11 Issue 4, p168 

    In this cohort study from France, pregnancy outcomes in women with IBD who were treated with thiopurines were examined. There was no difference in the numbers of live births, prematurity, birth weight, rate of low birth weight, and number of congenital abnormalities between those who received...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics