Crohn Disease Flare Risk Increases in Pregnancy

Women who are pregnant and who have Crohn disease (CD) have a consistently high risk for flares during the peri-pregnancy period, results of a new study showed. In response, the researchers say there is need to optimize the management of CD.

The study, authored by Dr Edward Lee and colleagues, was presented at the AIBD meeting this week.

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Participants who had CD and who had a pregnancy resulting in a live birth were identified through the MarketScan database (January 2010 to September 2016). The participants had to have stayed enrolled from baseline (6-months pre-index) through the postpartum period (6-months post-delivery).

In all, the researchers identified 1726 participants.

The researchers developed 7 clinical proxies to assess flares during the study period

Among the 1726 pregnancies, there were 5074 flares. Overall, 25% occurred during baseline, 43.9% occurred during pregnancy, and 31.1% occurred during the postpartum period. The average monthly flare rates were 211.3 during baseline, 241.7 during pregnancy, and 263.2 during postpartum.

An increase in CD-related outpatient visits from baseline (23.7%) and CD-related symptoms (23.0%) were the most frequent clinical proxies for flares during the baseline period.

The most frequent clinical proxies for flares during both the pregnancy and postpartum periods were the addition or increase in dose of CD-indicated therapies (45.6% pregnancy period, 35.8% postpartum period) and CD-related complications (25.0% pregnancy period, 35.4% postpartum period).

“The use of clinical proxies to explore national trends in CD disease control might help uncover unmet needs,” the researchers concluded. “Healthcare professionals should aim for disease control prior to pregnancy and have a treatment plan during and after pregnancy to optimize clinical outcomes and minimize CD-related complications for women.”

—Colleen Murphy

Reference:

Lee E, Suruki R, Fowler R, et al. Incidence of peri-pregnancy flares among patients with Crohn’s disease. Paper presented at: Advances in Inflammatory Bowel Diseases; December 13-15, 2018; Orlando, FL. https://www.consultant360.com/meeting-materials/incidence-peri-pregnancy-flares-among-patients-crohns-disease. Accessed November 28, 2018.

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