Fecal Calprotectin Is Not Affected by Pregnancy

Clinical Implications for the Management of Pregnant Patients with Inflammatory Bowel Disease

Mette Julsgaard*, Christian L. Hvas, Richard B. Gearry, Thea Vestergaard, Jan Fallingborg, Lise Svenningsen, Jens Kjeldsen, Miles P. Sparrow, Signe Wildt, Jens Kelsen, Sally J. Bell

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

Background: Noninvasive biomarkers of inflammation for monitoring inflammatory bowel disease (IBD) are important in pregnancy. Clinical and laboratory markers are often affected by the physiological adaption that occurs during pregnancy, although, few, if any, data exist on fecal calprotectin (FC). We investigated FC concentrations in pregnant controls and IBD women, and whether FC correlated with physician global assessment (PGA), C-reactive protein (CRP), and Harvey-Bradshaw Index (HBI)/Simple Clinical Colitis Activity Index (SCCAI) before and after pregnancy, as well as during each trimester. Methods: The study is a prospective multicenter study of 46 pregnant women with and 21 without IBD in Denmark, Australia, and New Zealand. Demographics, clinical parameters, and HBI/SCCAI were recorded. Stool and blood samples were obtained to determine FC and CRP concentrations. Results: From pregnant IBD women and pregnant controls, 174 and 21 fecal samples were collected, respectively. The median FC concentration in pregnant IBD women was 131 g/g (range 0-3600) and in controls 0 g/g (range 0-84) (P < 0.0001). FC strongly correlated with PGA at all 5 timepoints (r ≥ 0.80; P < 0.0001) and with HBI/SCCAI before (r = 0.66; P < 0.0001) and after pregnancy (r = 0.47; P < 0.003) but not during pregnancy (P > 0.05). An FC cutoff concentration of 250 g/g significantly correlated with active disease according to PGA in all 5 periods (P ≤ 0.0002). CRP only significantly correlated with FC (P = 0.0007) and PGA in the second trimester (P = 0.0003). No significant correlation was found between CRP and HBI/SCCAI at any timepoint (P > 0.05). Conclusions: The physiological changes that occur during pregnancy do not affect FC, in contrast to CRP and HBI/SCCAI. The combined use of FC and PGA seems optimal to assess disease activity in IBD during pregnancy.

Original languageEnglish
JournalInflammatory Bowel Diseases
Volume23
Issue number7
Pages (from-to)1240-1246
ISSN1078-0998
DOIs
Publication statusPublished - 2017

Fingerprint

Inflammatory Bowel Diseases
Colitis
Physicians
Pregnant Women
Second Pregnancy Trimester
Denmark
New Zealand
Multicenter Studies
Prospective Studies

Keywords

  • C-reactive protein
  • disease activity
  • fecal calprotectin
  • Harvey-Bradshaw Index
  • inflammatory bowel disease
  • physician global assessment
  • pregnancy
  • Simple Clinical Colitis Activity Index

Cite this

Julsgaard, Mette ; Hvas, Christian L. ; Gearry, Richard B. ; Vestergaard, Thea ; Fallingborg, Jan ; Svenningsen, Lise ; Kjeldsen, Jens ; Sparrow, Miles P. ; Wildt, Signe ; Kelsen, Jens ; Bell, Sally J. / Fecal Calprotectin Is Not Affected by Pregnancy : Clinical Implications for the Management of Pregnant Patients with Inflammatory Bowel Disease. In: Inflammatory Bowel Diseases. 2017 ; Vol. 23, No. 7. pp. 1240-1246.
@article{3719e04863b34d1399fa1238c0ae423c,
title = "Fecal Calprotectin Is Not Affected by Pregnancy: Clinical Implications for the Management of Pregnant Patients with Inflammatory Bowel Disease",
abstract = "Background: Noninvasive biomarkers of inflammation for monitoring inflammatory bowel disease (IBD) are important in pregnancy. Clinical and laboratory markers are often affected by the physiological adaption that occurs during pregnancy, although, few, if any, data exist on fecal calprotectin (FC). We investigated FC concentrations in pregnant controls and IBD women, and whether FC correlated with physician global assessment (PGA), C-reactive protein (CRP), and Harvey-Bradshaw Index (HBI)/Simple Clinical Colitis Activity Index (SCCAI) before and after pregnancy, as well as during each trimester. Methods: The study is a prospective multicenter study of 46 pregnant women with and 21 without IBD in Denmark, Australia, and New Zealand. Demographics, clinical parameters, and HBI/SCCAI were recorded. Stool and blood samples were obtained to determine FC and CRP concentrations. Results: From pregnant IBD women and pregnant controls, 174 and 21 fecal samples were collected, respectively. The median FC concentration in pregnant IBD women was 131 g/g (range 0-3600) and in controls 0 g/g (range 0-84) (P < 0.0001). FC strongly correlated with PGA at all 5 timepoints (r ≥ 0.80; P < 0.0001) and with HBI/SCCAI before (r = 0.66; P < 0.0001) and after pregnancy (r = 0.47; P < 0.003) but not during pregnancy (P > 0.05). An FC cutoff concentration of 250 g/g significantly correlated with active disease according to PGA in all 5 periods (P ≤ 0.0002). CRP only significantly correlated with FC (P = 0.0007) and PGA in the second trimester (P = 0.0003). No significant correlation was found between CRP and HBI/SCCAI at any timepoint (P > 0.05). Conclusions: The physiological changes that occur during pregnancy do not affect FC, in contrast to CRP and HBI/SCCAI. The combined use of FC and PGA seems optimal to assess disease activity in IBD during pregnancy.",
keywords = "C-reactive protein, disease activity, fecal calprotectin, Harvey-Bradshaw Index, inflammatory bowel disease, physician global assessment, pregnancy, Simple Clinical Colitis Activity Index",
author = "Mette Julsgaard and Hvas, {Christian L.} and Gearry, {Richard B.} and Thea Vestergaard and Jan Fallingborg and Lise Svenningsen and Jens Kjeldsen and Sparrow, {Miles P.} and Signe Wildt and Jens Kelsen and Bell, {Sally J.}",
year = "2017",
doi = "10.1097/MIB.0000000000001136",
language = "English",
volume = "23",
pages = "1240--1246",
journal = "Inflammatory Bowel Diseases",
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Julsgaard, M, Hvas, CL, Gearry, RB, Vestergaard, T, Fallingborg, J, Svenningsen, L, Kjeldsen, J, Sparrow, MP, Wildt, S, Kelsen, J & Bell, SJ 2017, 'Fecal Calprotectin Is Not Affected by Pregnancy: Clinical Implications for the Management of Pregnant Patients with Inflammatory Bowel Disease', Inflammatory Bowel Diseases, vol. 23, no. 7, pp. 1240-1246. https://doi.org/10.1097/MIB.0000000000001136

Fecal Calprotectin Is Not Affected by Pregnancy : Clinical Implications for the Management of Pregnant Patients with Inflammatory Bowel Disease. / Julsgaard, Mette; Hvas, Christian L.; Gearry, Richard B.; Vestergaard, Thea; Fallingborg, Jan; Svenningsen, Lise; Kjeldsen, Jens; Sparrow, Miles P.; Wildt, Signe; Kelsen, Jens; Bell, Sally J.

In: Inflammatory Bowel Diseases, Vol. 23, No. 7, 2017, p. 1240-1246.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - Fecal Calprotectin Is Not Affected by Pregnancy

T2 - Clinical Implications for the Management of Pregnant Patients with Inflammatory Bowel Disease

AU - Julsgaard, Mette

AU - Hvas, Christian L.

AU - Gearry, Richard B.

AU - Vestergaard, Thea

AU - Fallingborg, Jan

AU - Svenningsen, Lise

AU - Kjeldsen, Jens

AU - Sparrow, Miles P.

AU - Wildt, Signe

AU - Kelsen, Jens

AU - Bell, Sally J.

PY - 2017

Y1 - 2017

N2 - Background: Noninvasive biomarkers of inflammation for monitoring inflammatory bowel disease (IBD) are important in pregnancy. Clinical and laboratory markers are often affected by the physiological adaption that occurs during pregnancy, although, few, if any, data exist on fecal calprotectin (FC). We investigated FC concentrations in pregnant controls and IBD women, and whether FC correlated with physician global assessment (PGA), C-reactive protein (CRP), and Harvey-Bradshaw Index (HBI)/Simple Clinical Colitis Activity Index (SCCAI) before and after pregnancy, as well as during each trimester. Methods: The study is a prospective multicenter study of 46 pregnant women with and 21 without IBD in Denmark, Australia, and New Zealand. Demographics, clinical parameters, and HBI/SCCAI were recorded. Stool and blood samples were obtained to determine FC and CRP concentrations. Results: From pregnant IBD women and pregnant controls, 174 and 21 fecal samples were collected, respectively. The median FC concentration in pregnant IBD women was 131 g/g (range 0-3600) and in controls 0 g/g (range 0-84) (P < 0.0001). FC strongly correlated with PGA at all 5 timepoints (r ≥ 0.80; P < 0.0001) and with HBI/SCCAI before (r = 0.66; P < 0.0001) and after pregnancy (r = 0.47; P < 0.003) but not during pregnancy (P > 0.05). An FC cutoff concentration of 250 g/g significantly correlated with active disease according to PGA in all 5 periods (P ≤ 0.0002). CRP only significantly correlated with FC (P = 0.0007) and PGA in the second trimester (P = 0.0003). No significant correlation was found between CRP and HBI/SCCAI at any timepoint (P > 0.05). Conclusions: The physiological changes that occur during pregnancy do not affect FC, in contrast to CRP and HBI/SCCAI. The combined use of FC and PGA seems optimal to assess disease activity in IBD during pregnancy.

AB - Background: Noninvasive biomarkers of inflammation for monitoring inflammatory bowel disease (IBD) are important in pregnancy. Clinical and laboratory markers are often affected by the physiological adaption that occurs during pregnancy, although, few, if any, data exist on fecal calprotectin (FC). We investigated FC concentrations in pregnant controls and IBD women, and whether FC correlated with physician global assessment (PGA), C-reactive protein (CRP), and Harvey-Bradshaw Index (HBI)/Simple Clinical Colitis Activity Index (SCCAI) before and after pregnancy, as well as during each trimester. Methods: The study is a prospective multicenter study of 46 pregnant women with and 21 without IBD in Denmark, Australia, and New Zealand. Demographics, clinical parameters, and HBI/SCCAI were recorded. Stool and blood samples were obtained to determine FC and CRP concentrations. Results: From pregnant IBD women and pregnant controls, 174 and 21 fecal samples were collected, respectively. The median FC concentration in pregnant IBD women was 131 g/g (range 0-3600) and in controls 0 g/g (range 0-84) (P < 0.0001). FC strongly correlated with PGA at all 5 timepoints (r ≥ 0.80; P < 0.0001) and with HBI/SCCAI before (r = 0.66; P < 0.0001) and after pregnancy (r = 0.47; P < 0.003) but not during pregnancy (P > 0.05). An FC cutoff concentration of 250 g/g significantly correlated with active disease according to PGA in all 5 periods (P ≤ 0.0002). CRP only significantly correlated with FC (P = 0.0007) and PGA in the second trimester (P = 0.0003). No significant correlation was found between CRP and HBI/SCCAI at any timepoint (P > 0.05). Conclusions: The physiological changes that occur during pregnancy do not affect FC, in contrast to CRP and HBI/SCCAI. The combined use of FC and PGA seems optimal to assess disease activity in IBD during pregnancy.

KW - C-reactive protein

KW - disease activity

KW - fecal calprotectin

KW - Harvey-Bradshaw Index

KW - inflammatory bowel disease

KW - physician global assessment

KW - pregnancy

KW - Simple Clinical Colitis Activity Index

U2 - 10.1097/MIB.0000000000001136

DO - 10.1097/MIB.0000000000001136

M3 - Journal article

VL - 23

SP - 1240

EP - 1246

JO - Inflammatory Bowel Diseases

JF - Inflammatory Bowel Diseases

SN - 1078-0998

IS - 7

ER -