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Relationships between inflammatory bowel disease and perinatal factors: Both maternal and paternal disease are related to preterm birth of offspring

Bengtson, May-Bente MD1,*; Solberg, Inger Camilla MD2; Aamodt, Geir PhD3; Jahnsen, Jrgen PhD; Moum, Bjrn PhD; Vatn, Morten H. PhD5the IBSEN Study Group

doi: 10.1002/ibd.21120
Original Clinical Articles

Background: The aims of this study were to explore the influences of familial, maternal, and paternal inflammatory disease (IBD) on perinatal outcomes in the offspring and the risk for development of IBD related to perinatal factors.

Methods: Eighty-five patients with Crohn's disease (CD) and 86 with ulcerative colitis (UC) were included from a population-based incidence study enrolled 1990–1994. Family and birth records of these patients, as well as of their 207 infants, were drawn from the Norwegian Medical Birth Registry, established in 1967, and compared with the national birth cohort from the same period.

Results: Maternal (odds ratio [OR] = 2.15, 95% confidence interval [CI]: 1.36, 3.39) and paternal IBD (OR = 3.02, 95% CI: 1.82, 5.01) influenced the risk of preterm birth (<37 weeks), which further increased if the affected parents had a first-degree relative with IBD (OR = 4.29, 95% CI: 1.59, 11.63). Maternal CD was associated with lower birth weight in the offspring (crude difference: 271.79 g, 95% CI: 87.83, 455.77, versus controls). Maternal UC increased the risk of perinatal bacterial infection in the offspring (OR = 6.03, 95% CI: 2.03, 17.91). IBD patients (2.3%) were less likely to be delivered by cesarean section than controls (8.1%) (OR = 0.27, CI: 95%: 0.10, 0.73).

Conclusions: Familial, maternal, and paternal IBD were linked to preterm birth, which might be explained by genetic mechanisms. The present protective effect of cesarean sections needs further clarification in future studies. Inflamm Bowel Dis 2009

1Medical Department, Tonsberg County Hospital, Oslo, Norway

2Department of Gastroenterology, Ullevål University Hospital, Oslo, Norway

3Norwegian Institute of Public Health, Oslo, Norway

4Medical Department Aker University Hospital, University of Oslo, Oslo, Norway

5EpiGen, Faculty Division Akershus University, University Hospital of Oslo and Medical Department, Rikshospitalet University Hospital, Oslo, Norway

*Reprints: Lokesvei 10, Åsgårdstand 3179, Norway. e-mail:

Received 23 August 2009; Accepted 27 August 2009

Supported by South-Eastern Regional Health Authority.

Published online 30 September 2009 in Wiley InterScience (

© Crohn's & Colitis Foundation of America, Inc.
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