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Crohn’s disease poses increased risk of ectopic pregnancy

14 Sep 2017

Women with Crohn’s disease are at greater risk of ectopic pregnancies compared with those who do not have inflammatory bowel disease (IBD), a recent study suggests. Moreover, undergoing a surgery for IBD prior to pregnancy appears to contribute to a nonsignificant increase in risk of the pregnancy complication.

Using a large national patient registry in Denmark, researchers evaluated the risk of an ectopic pregnancy over a 22-year period in 7,548 pregnancies in women with ulcerative colitis, 6,731 pregnancies in women with CD and 1,832,732 pregnancies in those without IBD. Disease-specific risks of ectopic pregnancies were also evaluated in pregnancies of women with UC or CD who underwent IBD-related surgical procedures.

Logistic regression analysis found that the risk of ectopic pregnancy, per pregnancy, was higher in women with CD (odds ratio [OR], 1.23; 95 percent CI, 1.01 to 1.49) and did not increase in women with UC (OR, 0.98; 0.80 to 1.20) compared with women who did not have IBD.

Furthermore, a nonsignificant increase in risk of ectopic pregnancy was observed in pregnancies of women with CD or UC who underwent IBD-related surgery before pregnancy vs pregnancies in women with IBD who did not have surgery (CD: OR, 1.49; 0.91 to 2.44; UC: OR, 1.17; 0.54 to 2.52).

While the overall absolute risk of ectopic pregnancy remains low, the reported increase in relative risk of the said pregnancy complication in women with CD provides useful information for clinicians managing female IBD patients of reproductive age and heightens awareness of the possibility of ectopic complications in this patient group, researchers pointed out.

“In general, women with IBD should be educated about risk factors for EP such as pelvic infections and assisted reproductive technology,” researchers said, adding that the present data should be confirmed in other settings.

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