Article Text
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
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Footnotes
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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.