Crohn's disease as a risk factor for the outcome of pregnancy

Background/Aims: To study the effects of Crohn's disease on the course of p regnancy and the influence of pregnancy on the activity of Crohn's disease. Methodology: The course of 35 pregnancies in 23 women with Crohn's disease were reviewed over a 12 years period. Results: Nine pregnancies (25%) started when Crohn's disease was active. We observed 2 exacerbations among the 9 pregnancies with active disease and 7 exacerbations among the 26 pregnancies with quiescent disease: this repres ents a total exacerbation rate of 26% similar to non-pregnant women with Cr ohn's disease. The course of pregnancy was normal with a full-term delivery in 22 cases (63%). We observed 5 premature deliveries (14%), 5 spontaneous abortions (14%), 1 induced abortion (3%) and 2 liveborns with severe malfo rmations (6%). Preterm delivery was significantly associated with reactivat ion of Crohn's disease during pregnancy (P=0.009), whereas fetal loss was s ignificantly associated with activity of Crohn's disease at the time of con ception (P=0.015). Conclusions: Pregnancy does not appear to influence the course of Crohn's d isease. The relapse rate of Crohn's disease during pregnancy is similar to that of the general Crohn's disease population. Active Crohn's disease at t he time of conception or reactivation during pregnancy are risk factors for abnormal pregnancy outcome.