Influence of medical treatment, smoking and disease activity on pregnancy outcomes in Crohn's disease

Scand J Gastroenterol. 2014 Mar;49(3):302-8. doi: 10.3109/00365521.2013.879200. Epub 2014 Jan 13.


OBJECTIVE. Little is known about predictors for adverse pregnancy outcomes among women with Crohn's disease (CD). In this population-based study, we examined pregnancy outcomes in CD stratified by medical treatment and smoking status while accounting for disease activity. METHODS. In two Danish regions with a population of 1.6 million, we identified 154 CD women who had given birth within a 6-year period. We combined questionnaire data, prescription data, data from medical records and population-based medical databases. We used logistic regression to estimate prevalence odds ratios (POR) for adverse pregnancy outcomes by different predictors. RESULTS. Among 105 (80%) respondents, 55 (52%) reported taking medication during pregnancy. The majority (95%) were in disease remission. The children's mean birth weight did not differ by maternal medical treatment. As expected, smoking was a predictor of low birth weight. Mean birth weight in children of smokers in medical treatment was significantly reduced by 274 g compared with children of non-smokers who received medical treatment. In children of women without medical treatment, this difference was 126 g between smokers and non-smokers. Women in medical treatment did not have an increased risk of preterm delivery (POR 0.71; 95% confidence interval (CI) 0.18-2.79), congenital malformations (POR 0.60; 0.10-3.76) or cesarean section (POR 1.40; 0.63-3.08). CONCLUSIon. In CD, smoking was negatively associated with child birth weight. This association was most pronounced among women who received medical treatment. Maternal medical treatment for CD did not seem to be a risk factor for adverse pregnancy outcomes.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects*
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Birth Weight* / drug effects
  • Congenital Abnormalities / etiology
  • Crohn Disease / drug therapy*
  • Crohn Disease / physiopathology
  • Female
  • Humans
  • Immunosuppressive Agents / adverse effects*
  • Immunosuppressive Agents / therapeutic use
  • Induction Chemotherapy
  • Infant, Low Birth Weight
  • Infant, Newborn
  • Infant, Small for Gestational Age
  • Logistic Models
  • Odds Ratio
  • Pregnancy
  • Pregnancy Complications / drug therapy*
  • Pregnancy Complications / physiopathology
  • Pregnancy Outcome*
  • Premature Birth / etiology
  • Retrospective Studies
  • Risk Factors
  • Severity of Illness Index
  • Smoking / adverse effects*
  • Stillbirth


  • Anti-Inflammatory Agents, Non-Steroidal
  • Immunosuppressive Agents