St Vincent’s Hospital Melbournes study monitors pregnant women with IBD

World-first research suggests treating a common chronic illness this way during pregnancy can prevent serious birth complications.

A new study has monitored pregnant women with IBD

World-first Australian research suggests treating a common chronic illness during pregnancy can prevent serious birth complications months later.

Women who have inflammatory bowel disease and fall pregnant are at higher risk of maternal complications, such as premature birth and pre-eclampsia.

But a new study from St Vincent’s Hospital Melbourne (SVHM) and Monash Health shows using an intestinal ultrasound to track flare-ups of the disease can predict both mothers and babies’ risk of several serious birth complications.

SVHM gastroenterologist and co-author Dr Emma Flanagan said doctors could then help pregnant IBD patients reduce their risk by preventing and treating these flare-ups.

“Achieving and maintaining disease remission before conception and early in pregnancy reduces the chance of flare-ups and complications,” she said.

“It (an ultrasound) is a quick and safe test during pregnancy and we can show women at the time if there’s active inflammation in the bowel, then treat it straight away to try and make sure the inflammation’s under the best possible control.”

She said IBD, which covers the conditions Crohn’s disease and ulcerative colitis and impacts about 180,000 Australians, occurred when there was “chronic inflammation of the gastrointestinal tract”.

“Patients can suffer from symptoms such as diarrhoea, abdominal pain, nutritional deficiencies and weight loss,” she said.

“Australia has one of the highest rates of IBD in the world and the symptoms can be really debilitating.”

The study, published in the Gastroenterology journal, found women with active IBD in their first or second trimester were at a higher risk for various maternity complications when compared to those whose IBD was in remission.

Among pregnant women with active IBD, almost one in four had babies that needed care on an intensive or special care ward and one in eight mothers had gestational diabetes.

But Dr Flanagan said their research showed intestinal ultrasound could not only be used to safely detect signs of active IBD during pregnancy, but was actually more accurate than some of the standard assessment methods.

“Current methods used to assess IBD activity, such as clinical scores and blood tests, are often unreliable during pregnancy due to overlapping symptoms,” she said.

She said they believed it was inflammation that led to the poorer pregnancy outcomes associated with IBD.

“It’s extra physical stress on a woman’s body,” she said.

The study also found higher rates of a lower birth weight baby (5.8 per cent), pre-eclampsia (6 per cent) and premature delivery (5.9 per cent) in women with active IBD.

Almost 5 per cent gave birth – particularly if they had active disease at conception or in the first trimester – to babies with congenital anomalies.

Dr Flanagan said the Melbourne hospital, which runs a preconception and pregnancy clinic specifically for women with IBD, was also researching whether particular dietary changes can help manage symptoms.

Sofia and her son. Picture: Supplied

Melbourne Mum Sofia, a patient of the clinic now expecting her second child, said its support was incredible.

“I was able to stay very healthy throughout the (first) pregnancy, which was fantastic,” she said.

“But I also knew that if something did happen, they are very quick at responding.

“I felt like I had someone holding my hand through this.”

Originally published as St Vincent’s Hospital Melbournes study monitors pregnant women with IBD