A new study has found that people living with inflammatory bowel disease (IBD) are not at increased risk of high blood pressure problems during pregnancy overall, although certain specific risks, including preeclampsia, were higher. The findings may reassure many people with IBD who are pregnant or planning a pregnancy, while highlighting the value of closer monitoring during pregnancy.
Background
IBD includes conditions such as Crohn’s disease and ulcerative colitis, which cause ongoing inflammation in the digestive system. Because IBD can affect the body more widely, researchers have long been interested in whether it changes the risks associated with pregnancy, including problems linked to blood pressure such as gestational hypertension and preeclampsia. Preeclampsia is a condition where blood pressure rises during pregnancy and can affect other organs, requiring careful monitoring by a medical team.
What the Study Found
Researchers from Brigham and Women’s Hospital in Boston reviewed medical records from a single hospital, covering pregnancies delivered between 1998 and 2016. The study included 364 pregnancies in people with IBD and more than 45,000 pregnancies in people without the condition, allowing the researchers to compare outcomes between the two groups.
According to the study authors, there was no overall link between having IBD and developing high blood pressure problems in pregnancy as a whole. However, when they looked more closely, people with IBD had a higher likelihood of developing preeclampsia specifically, around two-thirds higher than those without IBD. There was no link found between IBD and gestational hypertension, which is high blood pressure without the other features of preeclampsia.
The researchers also reported other pregnancy differences linked to IBD. Pregnancies in people with IBD were more likely to result in premature birth, babies being smaller than expected for their stage of pregnancy, and delivery by caesarean section. No other meaningful differences were reported between the two groups.
Why This Matters
These findings help clarify a nuanced picture. People with IBD do not appear to face a broadly higher risk of blood pressure complications during pregnancy, which may ease some concerns. However, the increased likelihood of preeclampsia and other outcomes such as preterm delivery suggests that pregnancy in people with IBD may benefit from additional monitoring.
The study authors said the results support proactive, coordinated care during pregnancy, involving specialists such as high-risk obstetricians alongside the teams managing a person’s IBD. This kind of joined-up care could help identify and manage complications earlier, should they arise.
What to Keep in Mind
This was a single-centre study based on health records from one hospital, meaning the findings may not fully reflect experiences at other hospitals or in different populations. As an observational study, it can show links between IBD and pregnancy outcomes, but it cannot prove that IBD directly causes these differences. The study authors noted that several researchers involved had connections to pharmaceutical and medical technology companies, which is a standard disclosure and does not necessarily affect the study’s findings. Further research across multiple hospitals would help confirm these results and clarify how care during pregnancy might be improved for people with IBD.
Reference
Clarke LM, et al. [Study on inflammatory bowel disease and hypertensive disorders of pregnancy]. American Journal of Gastroenterology. 2023 (September issue). The full article title, volume, page numbers and DOI were not stated in the source material reviewed for this summary and could not be independently confirmed.
This article is a journalistic summary for informational purposes only. It does not constitute clinical advice or a recommendation to alter treatment decisions.