Maternal and Perinatal Outcomes in Pregnant Women With Comorbid Inflammatory Bowel Disease and Chronic Liver Disease.

BACKGROUND

Inflammatory bowel disease (IBD) and chronic liver disease (CLD) are each associated with adverse pregnancy outcomes, but the impact of coexisting IBD and CLD on pregnancy remains understudied.

AIMS: To assess CLD prevalence among pregnant women with and without IBD and evaluate maternal and perinatal outcomes.

METHODS

We conducted a retrospective cohort study of delivery hospitalisations among women ≥ 18 years using the 2016-2022 United States National Inpatient Sample. Deliveries were categorised as IBD + CLD, IBD, CLD or neither using ICD-10 codes. Weighted multivariable regression adjusted for demographics, comorbidities and cirrhosis.

RESULTS

Among 21,304,600 deliveries, 178,025 had CLD, 47,555 had IBD and 680 had IBD + CLD. Chronic viral hepatitis was the most common CLD, while autoimmune liver disease accounted for half of cirrhosis in IBD + CLD. Compared to IBD or CLD, IBD + CLD had higher odds of hyperemesis gravidarum (2.64 vs. 3.68), preterm birth (2.50 vs. 1.69), hypertensive disorders of pregnancy (HDP) (1.96 vs. 1.60), caesarean delivery (1.92 vs. 1.61), perinatal mood disorder (1.75 vs. 1.45) and premature rupture of membranes (1.35 vs. 1.39). IBD + CLD had greater odds of fetal death (1.97) versus CLD and of severe maternal morbidity (1.76) and postpartum haemorrhage (1.56) versus IBD. All p ≤ 0.05.

CONCLUSIONS

Coexisting IBD and CLD confer compounded maternal and perinatal risks beyond either condition alone. Multidisciplinary care and risk-based screening for underlying CLD in pregnant women are warranted.