"Even a modestly increased relative risk of preterm birth is important, given that preterm birth can greatly affect the child's health in both the short and the long term. If our results hold up in future studies, they may therefore be the basis for recommendations to confirm microscopic healing before pregnancy, to reduce such risks," he says. "Our results suggest that IBD treatment aimed at not merely alleviate symptoms of IBD, but also microscopically heal the intestine, can reduce the risk of giving birth preterm. The study's first author and corresponding author is Karl Mårild, associate professor of pediatrics at Sahlgrenska Academy, University of Gothenburg, and senior consultant pediatrician at the Department of Pediatrics, Queen Silvia Children's Hospital, Gothenburg. Through register linkages, data were also retrieved from several national health registers, such as the Swedish Medical Birth Register and the Swedish Quality Register for Inflammatory Bowel Desiease (SWIBREG). The study included 1,223 children of women with microscopic IBD inflammation of the intestine and 630 children of women with IBD but with microscopically healed intestinal mucosa. The results are based on register data on women in Sweden, diagnosed with IBD in 1990-2016, in whom information was available on the microscopic appearance of the intestine shortly before pregnancy. Microscopic inflammation was not clearly associated with other adverse pregnancy outcomes, such as growth restriction. This corresponds to a relative risk increase of 46 percent. The present study, published in the journal eClinicalMedicine, shows that microscopic inflammation in IBD, especially ulcerative colitis, is linked to an elevated risk of giving birth prematurely.Īmong babies born to women with microscopic inflammation due to IBD, 9.6 percent were preterm, while 6.5 percent of children were born preterm to women without microscopic inflammation of IBD. Until now, however, it has been unknown whether even microscopic inflammation may be associated with risks in pregnancy. IBD has previously been linked to negative birth outcomes, such as preterm birth (birth <37 weeks of pregnancy), mainly in women showing signs of active disease.Īlso, women without obvious IBD activity often have microscopic inflammation in the intestinal mucosa. Questions about its impact on pregnancy and the fetus are therefore common. Onset of IBD commonly occurs at age 15-30. Characteristic of IBD is its recurrent tendency for symptoms to flare up (relapse), followed periods of low or no disease activity (remission). IBD, which includes ulcerative colitis and Crohn's disease, and - unlike irritable bowel syndrome (IBS) - causes visible damage to the mucous membrane (mucosa) lining the intestines. Inflammatory bowel disease (IBD) is chronic inflammatory disease with a prevalence of approximately 0.5 percent.
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