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Background & Aims

Data on early adverse pregnancy outcomes in inflammatory bowel disease (IBD) such as ectopic pregnancy (EP) remain limited. We assessed the risk of EP in pregnancies of Danish women with IBD compared to all other Danish women over a 22-year period. In addition, we examined the disease-specific risk of EP in pregnancies of women with ulcerative colitis (UC) or Crohn's disease (CD) who underwent IBD-related surgical procedures.

Methods

We obtained nationwide data on all women of child-bearing age who had at least one pregnancy resulting in either an EP, hydatiform mole, induced abortion, miscarriage, or live birth from January 1994 through 2015. The cohorts comprised 7,548 UC; 6,731 CD; and 1,832,732 non-IBD pregnancies. Our primary outcome was EP per pregnancy. We controlled for multiple covariates, including pelvic and abdominal surgery.

Results

The risk of EP in pregnancies of women with CD or UC, compared to pregnancies of women without IBD was OR=1.23 (95% CI 1.01 -1.49), and OR= 0.98 (95% CI 0.80 -1.20), respectively. The risk of EP in pregnancies of women with CD or UC who had IBD-related surgery prior to pregnancy compared to pregnancies of women with IBD who had not had surgery was OR=1.49 (95% CI 0.91-2.44) for CD and OR=1.17 (95% CI 0.54-2.52) for UC.

Conclusion

We found a statistically significant increased risk of EP in pregnancies of women with CD compared to pregnancies of women without IBD. IBD surgery prior to pregnancy increased EP risk, though this was not statistically significant.