Abstract
BACKGROUND: Women with inflammatory bowel disease (IBD) and their children are at higher risk of adverse outcomes. The primary aim was to examine the association between IBD and adverse pregnancy outcomes. The secondary aim was to assess the impact of maternal IBD and medications used on children's outcomes. METHODS: This is a multicenter retrospective study in Saudi Arabia and Kuwait. Three participating hospitals enrolled women with IBD who gave birth between 2016 and 2023. Information regarding disease characteristics, medication use, pregnancy outcomes, and long-term health outcomes of children until age 14 years were collected. RESULTS: A total of 167 IBD pregnant women, a median age of 37.0 years (IQR: 33.0 to 44.0), were analyzed. Approximately 50% of women had three to six pregnancies. The most common pregnancy outcomes observed were low birth weight (22.5%) and small for gestational age (13.2%). A significant association was found between LBW and a history of smoking (p = 0.024) and Crohn's disease compared with ulcerative colitis (p = 0.018). Active flares or the need for steroids during pregnancy was significantly associated with adverse outcomes. 8.2% of the offspring were later diagnosed with IBD. A history of six or more pregnancies was identified as a significant predictor of IBD in offspring (OR = 4.02; 95% CI: 1.19-14.8, p < 0.01). None of the IBD medications used during pregnancy were associated with poor maternal or fetal outcomes. CONCLUSIONS: Infants of women with active IBD are at an increased risk of prematurity and being small for gestational age. The number of pregnancies is a novel predictor for IBD in an offspring.