Complications of Ileus and Bowel Obstruction During Pregnancy in Women Who Have Had Surgery for Inflammatory Bowel Disease: A population-based study

Objectives: Women with inflammatory bowel disease (IBD) who have IBD surgery before pregnancy have an increased risk of adverse maternal and fetal outcomes. Very few studies have examined the risks of gastrointestinal complications during pregnancy in this group of women. Methods: Using the Danish national registries, we identified live born children of mothers with ulcerative colitis (UC) or Crohn's disease (CD) who had IBD surgery before pregnancy. We compared the outcomes of ileus/bowel obstruction during pregnancy in women with UC or CD who had surgery compared to women with UC or CD who did not have surgery prior to pregnancy. Results: IBD surgery prior to pregnancy was more common in women with CD than in women with UC (31.5% versus 6.3%). For live births, 7.1% of mothers with UC surgery and 1.8% of mothers with CD surgery had a diagnosis of ileus/bowel obstruction during pregnancy. Patients who had UC surgery had an adjusted odds ratio (aOR) of 71.98 (95% CI 33.13-156.39) of an ileus/bowel obstruction compared to those with UC who had not had surgery. For UC: permanent ileostomies: aOR 128.69 (95% CI 57.57-287.63); ileoanal pouch anastomosis (IPAA) with diverting ostomy: aOR 40.14 (95% CI 11.19-143.96). Patients who had CD surgery had an aOR of 10.00 (95% CI 4.64-21.55). For CD: intestinal surgery (no stoma): aOR 7.96 (95% CI 3.48-18.22); intestinal surgery (with stoma): aOR 43.89 (95% CI 17.40-110.69). Conclusion: There is a significant risk of ileus/bowel obstruction during pregnancy in women who had IBD surgery prior to pregnancy.