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IBD, medications for expectant mothers unlikely to lead to major congenital anomalies
There is no evidence that pregnant women with inflammatory bowel disease or using standard medical therapy for IBD resulted in increased risk for a major congenital anomaly in their children, a study determined.
“This message may not have reached all pregnant women,” the researchers wrote. “About one-quarter of women stop their [IBD] medication in pregnancy.”
The study analyzed data on 386,514 children born to mothers aged 15 to 45 years in the United Kingdom between 1990 and 2010. Of these, 1,703 were born to mothers with IBD before childbirth.
The researchers then determined risk for major congenital anomalies in children of mothers with and without IBD and in children exposed or not exposed to 5-aminosalicylates, azathioprine/6-mercaptopurine or corticosteroids during their first trimester of development.
Among 384,811 controls, major anomalies occurred at a rate of 277 per 10,000 compared with a rate of 270 per 10,000 among children of mothers with IBD (adjusted OR=0.98; 95% CI, 0.73-1.31).
Children born to mothers with ulcerative colitis (UC) were at greater risk for congenital anomalies (aOR=1.34; 95% CI, 0.91-1.97) than those whose mothers had Crohn’s disease (CD) (aOR=0.68; 95% CI, 0.41-1.13).
Among children exposed to 5-aminosalicylates, corticosteroids and azathioprine/6-mercaptopurine, adjusted ORs were 0.82 (95% CI, 0.42–1.61), 0.48 (95% CI, 0.15–1.5) and 1.27 (95% CI, 0.48–3.39), respectively.
The study also found 31.2% of women with IBD discontinued their use of 5-aminosalicylates and 24.6% halted azathioprine/6-mercaptopurine use early in pregnancy. No flare-ups were demonstrated later in pregnancy despite stopping the medications.
The study was limited by its inability to validate information with the anonymous participants and may be underpowered in terms of comparing risks between UC and CD patients, the researchers wrote.
Disclosure: The researchers report no relevant financial disclosures.