Original ResearchFull Report: Clinical—Alimentary TractLimited Risks of Major Congenital Anomalies in Children of Mothers With IBD and Effects of Medications
Section snippets
Defining the Study Population
We studied all live singleton children born to women aged 15–45 years between 1990 and 2010 using an anonymized mother-child–linked data set from The Health Improvement Network, a nationally representative UK database of primary care records containing medical diagnoses, events, and drug prescriptions.22 For each mother-child pair, we defined women as having IBD in pregnancy if they had a diagnosis of IBD ever before childbirth or if they had a diagnosis after childbirth but prescriptions of
Results
Of 386,514 children, 0.4% were born to mothers who had IBD before childbirth (n = 1703) and 0.2% were born to mothers with CD (n = 893). Table 1 shows the maternal characteristics for children born to women with and without IBD. Compared with children in the control group, children in the IBD group were less likely to be from socioeconomically deprived areas, were more likely to be born later in the study period, and their mothers were slightly older (Table 1). However, children born to women
Principal Findings
This study is among the largest in terms of the number of women with IBD included, number of births, and number of major congenital anomalies that has yet been conducted to assess the risks of congenital anomalies among children of women with IBD. It showed no overall excess risk of a major congenital anomaly in children born to mothers with IBD and none associated with azathioprine/6-mercaptopurine, corticosteroids, or 5-aminosalicylate use within the maternal IBD population. The study also
Conclusions
We conclude that neither IBD, nor its common medical treatments, are likely to be major risk factors for congenital anomalies, but that this message may not have reached all pregnant women. About one quarter of women stop their medication in pregnancy. Although this may increase the risk of flares later in pregnancy, we were unable to show such increase.
Acknowledgments
All authors contributed to the conception and design of the study, and analysis and interpretation of the study results; Timothy Card, Laila Jal Tata, and Lu Ban drafted the manuscript; all authors revised the manuscript; and Timothy Card supervised the study and is the guarantor of the article.
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Cited by (0)
Conflicts of interest The authors disclose no conflicts.
Funding This study was funded by the National Association for Colitis and Crohn's Disease. The funders had no role in the conception, conduct, interpretation, or write-up of the study.