Article Text

Download PDFPDF

Impact of the coronavirus infectious disease (COVID-19) pandemic on the provision of inflammatory bowel disease (IBD) antenatal care and outcomes of pregnancies in women with IBD
  1. Christian Philipp Selinger1,
  2. Aileen Fraser2,
  3. Paul Collins3,
  4. Melanie Gunn4,
  5. Thean Soon Chew5,
  6. Georgina Kerry6,
  7. Kamal V Patel6,
  8. Maya Roysam1,
  9. Klaartje Bel Kok7,
  10. Aaron Bancil7,
  11. Veronica Hall8,
  12. Rachel Cooney9,
  13. Lyn Smith10,
  14. Helen Steed11,
  15. Jonathan Segal12,
  16. Alexandra Kent13,
  17. Jimmy Limdi14,
  18. Shaji Sebastian15
  1. 1Leeds Gastroenterology Institute, Leeds Teaching Hospitals NHS Trust, Leeds, UK
  2. 2Department of Gastroenterology, University Hospitals Bristol and Weston NHS Trust, Bristol, UK
  3. 3Department of Gastroenterology, Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, UK
  4. 4Department of Gastroenterology, Newcastle Hospitals NHS Foundation Trust, Newcastle, UK
  5. 5Academic Unit of Gastroenterology, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
  6. 6Department of Gastroenterology, St Georges Hospital, London, UK
  7. 7Department of Gastroenterology, Barts Health NHS Trust, London, UK
  8. 8Department of Gastroenterology, Bolton NHS Foundation Trust, Bolton, UK
  9. 9Department of Gastroenterology, University Hospitals Birmingham NHS Trust, Birmingham, UK
  10. 10Department of Gastroenterology, Glasgow Royal Infirmary, Glasgow, UK
  11. 11Gastroenterology, University of Wolverhampton, Wolverhampton, UK
  12. 12Department of Gastroenterology, The Hillingdon Hospital, Uxbridge, UK
  13. 13Gastroenterology, King's College Hospital NHS Foundation Trust, London, UK
  14. 14Pennine Acute Hospitals NHS Trust, Manchester Academic Health Sciences, University of Manchester, Manchester, UK
  15. 15IBD Unit, Hull University Teaching Hospitals NHS Trust, Hull, UK
  1. Correspondence to Christian Philipp Selinger; christian.selinger{at}web.de

Abstract

Background The impact of COVID-19 on pregnant inflammatory bowel disease (IBD) patients is currently unknown. Reconfiguration of services during the pandemic may negatively affect medical and obstetric care. We aimed to examine the impacts on IBD antenatal care and pregnancy outcomes.

Methods Retrospective data were recorded in consecutive patients attending for IBD antenatal care including outpatient appointments, infusion unit visits and advice line encounters.

Results We included 244 pregnant women with IBD, of which 75 (30.7%) were on biologics in whom the treatment was stopped in 29.3% at a median 28 weeks gestation. In addition, 9% of patients were on corticosteroids and 21.5% continued on thiopurines. The care provided during 460 patient encounters was not affected by the pandemic in 94.1% but 68.2% were performed via telephone (compared with 3% prepandemic practice; p<0.0001). One-hundred-ten women delivered 111 alive babies (mean 38.2 weeks gestation, mean birth weight 3324 g) with 12 (11.0%) giving birth before week 37. Birth occurred by vaginal delivery in 72 (56.4%) and by caesarean section in 48 (43.6%) cases. Thirty-three were elective (12 for IBD indications) and 15 emergency caesarean sections. Breast feeding rates were low (38.6%). Among 244 pregnant women with IBD, 1 suspected COVID-19 infection was recorded.

Conclusion IBD antenatal care adjustments during the COVID-19 pandemic have not negatively affected patient care. Despite high levels of immunosuppression, only a single COVID-19 infection occurred. Adverse pregnancy outcomes were infrequent.

  • inflammatory bowel disease
  • COVID-19
  • ulcerative colitis
  • Crohn's disease
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

Statistics from Altmetric.com

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Footnotes

  • Twitter @jonathansegal85

  • Contributors Study idea and design: SS, CPS and JS. Data collection: CPS, JS, AF, PC, MG, TSC, GK, KVP, MR, BKK, AB, VH, RC, AK, LS, JL and HS. Data analysis: CPS. Interpretation of results: all authors. Draft manuscript: CPS and JS. Critical review of draft manuscript: AF, PC, MG, TSC, GK, KVP, MR, BKK, AB, VH, RC, AK, LS, JL, HS and SS.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests CPS has received unrestricted research grants from Warner Chilcott, Janssen and AbbVie, has provided consultancy to Warner Chilcott, Dr Falk, AbbVie, Takeda, Fresenius Kabi and Janssen, and had speaker arrangements with Warner Chilcott, Dr Falk, AbbVie, MSD, Pfizer and Takeda. AF has received travel and accommodation grants from Takeda UK Ltd, Dr Falk Pharma, Abbvie Ltd, Ferring, Pharmacosmos, Allergan and Janssen. Has served on advisory boards for Takeda UK Ltd, Dr Falk Pharma, Abbvie Ltd, Ferring, Pharmacosmos, Allergan and Janssen and received speaker fees from Takeda UK Ltd, Dr Falk Pharma, Abbvie Ltd, Ferring, Pharmacosmos, Allergan and Janssen, Tillotts, Shield and Actavis. TSC has received unrestricted grants from Takeda as well as speaker fees from Pfizer and Falk. KVP has received honoraria for educational meetings and speaker fees from Abbvie, Janssen, Takeda, DrFalk and Ferring. KVP has received Advisory Board fees from Abbvie and Janssen. AK has served on the advisory boards for Abbvie, Janssen and BMS Celgene and has received speaker fees from Takeda, Pfizer and Janssen; and received travel/conference expenses from Tillotts, Janssen, Abbvie and Shield Therapeutics. JL has has received research grants from AbbVie and Galapagos and has provided consultancy to AbbVie, Arena Pharmaceuticals, Galapagos, Janssen, Pfizer and Takeda, and received speaker fees from Abbvie, MSD, Janssen, Pfizer and Takeda. SS holds research grants from Biogen, Takeda, AbbVie, Tillotts Pharma, Ferring and Biohit; served on the advisory boards of Takeda, AbbVie, Merck, Ferring, Pharmacocosmos, Warner Chilcott, Janssen, Falk Pharma, Biohit, TriGenix, Celgene and Tillots Pharma; and has received speaker fees from AbbVie, Biogen, AbbVie, Janssen, Merck, Warner Chilcott and Falk Pharma.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement No data are available. The study was performed as a clinical audit and hence we have no patient consent to publish raw data.