P459 Expression of SerpinE1, a potential new disease activity marker, reflects therapeutic response in Inflammatory Bowel Disease

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S453-S453
Author(s):  
B Jójrt ◽  
T Molnár ◽  
V Szabó ◽  
Á Varga ◽  
T Resál ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Disease Activity ◽  
Bowel Disease ◽  
Healthy Subjects ◽  
Expression Patterns ◽  
Invasive Disease ◽  
Gene Expressions ◽  
Inflammatory Bowel ◽  
Active Disease ◽  
Control Samples

Abstract Background Inflammatory Bowel Disease (IBD) occurs as a consequence of abnormal immune response generating unbalance between pro- and anti-inflammatory signalling. Analysis of cytokine profiles in view of different cytokine targeting or immunosuppressive therapy may open up new therapeutic targets and may reveal biological profiles that distinguish responders from non-responders before initiating therapy. The aim of present study was to determine cytokine profile of IBD patients and identify cytokines with predictive potential. Methods IBD patients with clinically active disease were enrolled in study. Blood and biopsy samples were obtained from 22 IBD patients and 5 healthy controls. Biopsies were taken from inflamed and non-inflamed part of colon of IBD patients. Total protein and mRNA were isolated from biopsy samples. Cytokine Array was used to analyse cytokine expression patterns. Serum and mucosal SerpinE1 levels were measured by ELISA and qRT-PCR. Results In samples from IBD patients, remarkable discrimination between inflamed, or non-inflamed areas was observed, whereas no pro-inflammatory cytokines were detected in control samples. SerpinE1 was presented in every inflamed biopsy samples, which was analyzed in more details. Mucosal expression of SerpinE1 differed significantly in healthy subjects compared to IBD patients with active disease (0 vs 24.06 pg/mg, p=0.02). After therapy induction a remarkable decrease was observed in the mucosal SerpinE1 concentration in responders (45.5 vs 9.7 pg/mg, p=0.02) versus non-responders (45 vs 61.2 pg/mg, p=0.3). Moreover, mean value of mucosal SerpinE1 did not differ significantly in healthy subjects compared to responders (5.7 vs. 0 pg/mg, p=0.12). In non-responders the fold changes of SerpinE1 gene expressions were significantly (p=0.001) higher than in responders. Lowest expression of SerpinE1 gene was measured in control samples, whereas the highest in untreated, inflamed biopsy samples. Serum and mucosal SerpinE1 concentrations were significantly higher in patients with active disease compared to inactive (tissue: 5 vs 47.4 pg/mg, p=0.00003; serum: 22.4 vs 25.94 mg/ml, p=0.022). Correlation analysis revealed that serum SerpinE1 correlates with disease activity (p<0,01, cut-off value: 22 mg/ml, sensitivity=80%, specificity=60%, accuracy=74%), whereas no correlation was observed between the mucosal SerpineE1 concentration and the disease activity (p>0.1, sensitivity=72%, specificity=77.8%, accuracy=73.5%). Conclusion These results suggest that serum and mucosal SeprinE1 expression reflects endoscopic activity of IBD. Correlation of SerpinE1expression between the blood and the bowel mucosa would open up new possibilities in non-invasive disease monitoring of IBD.

scholarly journals P430 Feasibility and reliability of gastrointestinal ultrasound in pregnant inflammatory bowel disease patients

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S391-S393
Author(s):  
F de Voogd ◽  
H Joshi ◽  
E Van Wassenaer ◽  
G D’Haens ◽  
K Gecse
Keyword(s):  
Inflammatory Bowel Disease ◽  
Disease Activity ◽  
Terminal Ileum ◽  
Bowel Disease ◽  
Activity Index ◽  
Third Trimester ◽  
Faecal Calprotectin ◽  
Gastrointestinal Ultrasound ◽  
Inflammatory Bowel ◽  
Active Disease

Abstract Background Disease activity during pregnancy in women with inflammatory bowel disease (IBD) is associated with miscarriage, preterm delivery and low birth weight. Monitoring disease activity throughout the pregnancy is therefore important. Gastrointestinal ultrasound (GIUS) has a high potential as a point-of-care tool for monitoring disease activity in IBD as it has been shown to correlate well with endoscopy and magnetic resonance imaging. However, data are scarce on the use of GIUS in IBD throughout pregnancy. The aim of this prospective study is to determine the feasibility and reliability of GIUS in pregnant IBD patients. Methods Patients were included when visiting the outpatient IBD pregnancy clinic. At each trimester, clinical and biochemical disease activity was evaluated and GIUS was performed. Feasibility was assessed by the ability to visualise each bowel segment (terminal ileum (TI), ascending (AC), transverse (TC), descending (DC) and sigmoid colon (SC)). Reliability was evaluated by using clinical and biochemical disease activity as a gold standard. This was defined as a Harvey–Bradshaw Index ≥4 in Crohn’s disease (CD) or a Simple Clinical Colitis Activity Index ≥5 in ulcerative colitis and a faecal calprotectin (FCP)³ 250 mg/g. Bowel wall thickness (BWT) of > 3 mm in the colon and > 2mm in the terminal ileum was considered as signs of active inflammation on ultrasound. A Mann–Whitney U-test and chi-square were used for statistical analysis. Results Thirty-two IBD patients (54% CD) were studied. Both a GIUS and FCP was available in 18, 11 and 6 patients for the first, second and third trimester, respectively. Eleven of 32 (34%) patients had clinically active disease at least at one time point during the pregnancy. Table 1 shows the visibility per segment. When the active disease was defined as an FCP ≥ 250 mg/g, GIUS could distinguish active from the non-active disease in the first, second and third trimester with a sensitivity of 80%, 75% and 75% and specificity of 85%, 86% and 100%, respectively. FCP levels were significantly higher in patients with an active disease on GIUS regardless of the trimester (mean 1095.5 ± 1453.8 mg/g vs. 265.25 ± 649.8 mg/g, p < 0.0001). Conclusion GIUS is accurate to distinguish active from the quiescent disease in pregnancy. Feasibility to visualise the TI and the SC decreased during the second and third trimester, although active disease could still be detected. Consequently, GIUS is feasible and reliable to assess disease activity throughout pregnancy in IBD.

scholarly journals The Possible Role of the Novel Cytokines IL-35 and IL-37 in Inflammatory Bowel Disease

2014 ◽  
Vol 2014 ◽  
pp. 1-10 ◽  
Author(s):  
Yanmei Li ◽  
Yanan Wang ◽  
Ying Liu ◽  
Yatian Wang ◽  
Xiuli Zuo ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Healthy Subjects ◽  
Inflammatory Diseases ◽  
Inflammatory Cells ◽  
Intestinal Epithelial ◽  
Gene Expressions ◽  
Expression Studies ◽  
Novel Biomarkers ◽  
Inflammatory Bowel

Interleukin- (IL-) 35 and IL-37 are newly discovered immune-suppressing cytokines. They have been described in inflammatory diseases such as collagen-induced arthritis and asthma. However, their expressions in inflammatory bowel disease (IBD) patients have not been yet explored. Our aim was to evaluate serum and inflamed mucosal levels in IBD patients. In 20 ulcerative colitis (UC) patients, 7 Crohn’s disease (CD) patients, and 15 healthy subjects, cytokine levels in serum were determined using ELISA and mucosal expression studies were performed by immunohistochemistry, quantitative real-time PCR, and Western blot. The results showed that serums IL-35 and IL-37 levels were significantly decreased in UC and CD patients compared with healthy subjects. The cytokines levels correlated inversely with UC activity. IL-35 was expressed in infiltrating immune cells while IL-37 in intestinal epithelial cells as well as inflammatory cells. IBD patients had significantly higherEbi3,p35(two subunits of IL-35), andIL-37bgene expressions; IL-35 and IL-37 protein expressions were higher in IBD patients compared with controls. The study showed that serums IL-35 and IL-37 might be potentially novel biomarkers for IBD. Intestinal IL-35 and IL-37 proteins are upregulated, suggesting that regulating the expression of the two cytokines may provide a new possible target for the treatment of IBD.

scholarly journals Intestinal Ultrasound to Evaluate Treatment Response During Pregnancy in Patients With Inflammatory Bowel Disease

2021 ◽  
Author(s):  
Floris De Voogd ◽  
Harshad Joshi ◽  
Elsa Van Wassenaer ◽  
Steven Bots ◽  
Geert D’Haens ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Disease Activity ◽  
Treatment Response ◽  
Bowel Disease ◽  
Objective Evaluation ◽  
Fecal Calprotectin ◽  
Clinical Activity ◽  
Third Trimester ◽  
Inflammatory Bowel ◽  
Active Disease

Abstract Introduction Active disease in inflammatory bowel disease patients during pregnancy is associated with poor maternal and fetal outcomes. Objective evaluation of disease activity is a core strategy in IBD, and during pregnancy noninvasive modalities are preferred. We aimed to evaluate feasibility and accuracy of intestinal ultrasound (IUS) to objectify disease activity throughout pregnancy. Methods Pregnant patients with known IBD were included and followed throughout pregnancy for clinical disease activity, with fecal calprotectin (FCP) and with IUS every trimester. Feasibility of IUS was assessed for all colonic segments and terminal ileum (TI). Intestinal ultrasound outcomes to detect active disease and treatment response were compared with clinical scores combined with FCP. Results In total, 38 patients (22 CD, 16 UC) were included, with 27 patients having serial IUS. Feasibility of IUS decreases significantly in third trimester for TI (first vs third trimester: 91.3% vs 21.7%, P < .0001) and sigmoid (first vs third trimester: 95.6% vs 69.5%, P = .023). Intestinal ultrasound activity showed moderate to strong correlation with clinical activity (r = 0.60, P < .0001) and FCP (r = 0.73, P < .0001). Throughout pregnancy, IUS distinguished active from quiescent disease with 84% sensitivity and 98% specificity according to FCP combined with clinical activity. IUS showed disease activity in >1 segment in 52% of patients and detected treatment response with 80% sensitivity and 92% specificity. Conclusions IUS is feasible and accurate throughout pregnancy, although visualization of the sigmoid and TI decreases in the third trimester. IUS provides objective information on disease activity, extent, and treatment response, even during second and third trimester, and offers a noninvasive strategy to closely monitor patients during pregnancy.

scholarly journals Elevated ectodomain of type 23 collagen is a novel biomarker of the intestinal epithelium to monitor disease activity in ulcerative colitis and Crohn’s disease

2020 ◽  
pp. 205064062097737
Author(s):  
T Manon-Jensen ◽  
S Sun ◽  
M Lindholm ◽  
V Domislović ◽  
P Giuffrida ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Disease Activity ◽  
Bowel Disease ◽  
Surrogate Marker ◽  
Area Under The Curve ◽  
Inflammatory Bowel ◽  
Active Disease

Background Impaired intestinal epithelial barrier is highly affected in inflammatory bowel disease. Transmembrane collagens connecting the epithelial cells to the extracellular matrix have an important role in epithelial cell homeostasis. Thus, we sought to determine whether the transmembrane type 23 collagen could serve as a surrogate marker for disease activity in patients with Crohn’s disease and ulcerative colitis. Methods We developed an enzyme-linked immunosorbent assay to detect the ectodomain of type 23 collagen (PRO-C23) in serum, followed by evaluation of its levels in both acute and chronic dextran sulfate sodium colitis models in rats and human inflammatory bowel disease cohorts. Serum from 44 Crohn’s disease and 29 ulcerative colitis patients with active and inactive disease was included. Results In the acute and chronic dextran sulfate sodium-induced rat colitis model, the PRO-C23 serum levels were significantly increased after colitis and returned to normal levels after disease remission. Serum levels of PRO-C23 were elevated in Crohn’s disease ( p < 0.05) and ulcerative colitis ( p < 0.001) patients with active disease compared to healthy donors. PRO-C23 differentiated healthy donors from ulcerative colitis (area under the curve: 0.81, p = 0.0009) and Crohn’s disease (area under the curve: 0.70, p = 0.0124). PRO-C23 differentiated ulcerative colitis patients with active disease from those in remission (Area under the curve: 0.75, p = 0.0219) and Crohn’s disease patients with active disease from those in remission (area under the curve: 0.68, p = 0.05). Conclusion PRO-C23 was elevated in rats with active colitis, and inflammatory bowel disease patients with active disease. Therefore, PRO-C23 may be used as a surrogate marker for monitoring disease activity in ulcerative colitis and Crohn’s disease.

P810 Geriatric impairments in older inflammatory bowel disease patients are associated with higher disease burden: results of a multicentre cohort study

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S632-S633
Author(s):  
V Asscher ◽  
S Waars ◽  
A van der Meulen-de Jong ◽  
R Stuyt ◽  
S Brouwer ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Disease Activity ◽  
Bowel Disease ◽  
Disease Burden ◽  
Handgrip Strength ◽  
Improve Patient Care ◽  
Adverse Outcomes ◽  
Functional Domain ◽  
Inflammatory Bowel ◽  
Active Disease

Abstract Background The population of older patients with Inflammatory Bowel Diseases (IBD) is expanding. Knowledge on the prevalence and impact of geriatric impairments is scarce in this heterogenous group. In other fields of medicine, it has been established that geriatric impairments associate with adverse outcomes. Therefore, the aims of our study were to assess the prevalence of geriatric impairments in older IBD patients and to evaluate the association between geriatric impairments and disease burden of IBD through the short Inflammatory Bowel Disease Questionnaire (sIBDQ). Methods Consecutive IBD patients aged ≥65 years were included at outpatient departments and infusion centres of four hospitals in The Netherlands. Comorbidity, polypharmacy and malnutrition (somatic domain), cognitive impairment and depressive symptoms (mental domain), handgrip strength and gait speed (physical domain) and impairments in (instrumental) activities of daily living ((I)ADL) (functional domain) were assessed. Disease activity was assessed through Harvey Bradshaw Index (HBI) or partial Mayo Score (pMS) (remission: HBI&lt;5 or pMS&lt;2); The sIBDQ was used to assess IBD disease burden. Association between geriatric impairments and sIBDQ was assessed using multiple linear regression, including confounders age, sex, IBD type, disease duration and disease activity. Results In total, 336 patients were included: median age 70.0 (IQR 67.0–73.0); 161 CD (47.9%); 71 active disease (21.1%); mean sIBDQ 59.7 (SD 8.1). Prevalence of geriatric impairments is tabulated (Table 1). Both active disease and the presence of two or more impaired domains were statistically significantly and independently associated with a higher disease burden (lower sIBDQ) (Table 2). Conclusion In an older IBD patient population, geriatric impairments are frequently encountered and associate with a higher disease burden. These results are a call for more research on the relationship between geriatric impairments and IBD disease burden to improve patient care in older IBD patients.

scholarly journals A172 THE ASSOCIATION OF EFFICACY, OPTIMISM, UNCERTAINTY AND HEALTH ANXIETY IN INFLAMMATORY BOWEL DISEASE ACTIVITY OVER TIME

2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 183-184
Author(s):  
J Stone ◽  
L Shafer ◽  
L A Graff ◽  
K Witges ◽  
L Lix ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Disease Activity ◽  
Bowel Disease ◽  
Psychological Functioning ◽  
Self Efficacy ◽  
Health Anxiety ◽  
Self Report ◽  
Psychological Attributes ◽  
Inflammatory Bowel ◽  
Active Disease

Abstract Aims We aimed to assess if the presence of positive or negative psychological attributes are associated with disease activity in a prospective inflammatory bowel disease (IBD) cohort using validated psychological assessment tools and various measures of disease activity. Methods The study included 146 adults with confirmed and recently active IBD enrolled in a prospective longitudinal cohort study. Demographics, disease information, validated measures of psychological functioning related to self-efficacy, optimism, health anxiety and intolerance of uncertainty were collected at baseline, week 26 and week 52. Disease activity indicators included fecal calprotection (FCAL), the Inflammatory Bowel Disease Symptom Inventory (IBDSI), and self-reported flares and were collected at study baseline, week 26 and week 52. Logistic regression was used to identify the relationship between psychological functioning and disease activity. Results Participants’ mean age was 42.9 years (SD 12.6; range 18–70), with 70.5% women. Almost two thirds (65.1%) had a diagnosis of Crohn’s disease (CD), 34.2% had ulcerative colitis (UC), and 0.7% (n=1) was IBD unclassified. 22% had income &lt;$50,000 and 63% were in a current relationship. Patient-reported active disease (i.e., IBDSI; flare self-report) was significantly less likely with higher self-efficacy [OR= 0.87, 95% CI 0.82–0.93 (IBDSI); OR= 0.86, 95% CI 0.81–0.91 (self-report)] and significantly more likely with higher health anxiety (OR=1.09, 95% CI 1.04–1.15) with the association remaining for self-reported flares after adjusting for demographic variables. The psychological attributes were not associated with active disease based on FCAL levels. Conclusions Higher health anxiety increases the likelihood of experiencing an IBD flare, while higher general self-efficacy may be protective of a disease flare. Funding Agencies None

scholarly journals P345 Food-related quality of life in adults with Inflammatory Bowel Disease is influenced by restrictive eating behaviour, disease activity and surgery: a prospective multi-centre study

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S368-S369
Author(s):  
A Day ◽  
C K Yao ◽  
S Costello ◽  
J Andrews ◽  
R Bryant
Keyword(s):  
Quality Of Life ◽  
Inflammatory Bowel Disease ◽  
Disease Activity ◽  
Bowel Disease ◽  
Eating Behaviour ◽  
Restrictive Eating ◽  
Related Quality ◽  
Inflammatory Bowel ◽  
Active Disease

Abstract Background Measuring food-related quality of life (FRQoL) quantifies the psychosocial impact of eating and drinking.1 The influences on FRQoL in people with inflammatory bowel disease (IBD) are not well explored, despite IBD being a chronic disease affecting the digestive tract. This study aimed to characterise and identify any patient or disease-related predictors of FRQoL in individuals with IBD. Methods Adults with a formal diagnosis of IBD were recruited to a prospective multi-centre cross-sectional study between April 2018 and December 2019. Participants completed questionnaires measuring FRQoL (IBD-FRQoL-29: minimum/poor 29, maximum/greatest 145), clinical disease activity (active disease: Harvey Bradshaw Index &gt;4 active disease, Simple Clinical Colitis Activity Index &gt;2, restrictive eating behaviour (Nine Item Avoidant/Restrictive Screen: minimum 0, maximum 45), mental health (DASS-21: minimum 0, maximum 126) and other patient and disease-related variables. Results One hundred and eight participants completed the questionnaires. The majority of the cohort had UC (69/108, 64%) and there was almost equal distribution of those with quiescent (48%) and active (52%) disease The mean FRQoL of individuals with IBD was 79 (95% CI 75, 84) (see Figure 1). Poorer FRQoL was seen in those with restrictive eating behaviour associated with fear of a negative consequence from eating (p&lt;0.0001) and reduced appetite (p&lt;0.030). Greater FRQoL was seen in those with lower disease activity (p&lt;0.0001) and previous IBD surgery (p=0.240). FRQoL was not influenced either way by IBD phenotype, duration, or gender. The majority of participants obtained their dietary information from the internet (60%) or gastroenterologist (46%). Conclusion FRQoL in people with IBD is poorer in those with restrictive eating behaviours and clinically active disease. Interestingly, it was greater in those with previous IBD surgery. Further research is required to validate these associations and explore longitudinal effects of poor FRQoL on patient outcomes and potential strategies for prevention or management of impaired FRQoL in IBD. Reference

scholarly journals P166 Inflammatory bowel disease: risk factors to disease activity during pregnancy and postpartum

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S221-S221
Author(s):  
R Vicente Costa ◽  
P Currais ◽  
C Simões ◽  
L Pinto ◽  
L Correia
Keyword(s):  
Inflammatory Bowel Disease ◽  
Disease Activity ◽  
Bowel Disease ◽  
Statistical Tests ◽  
Bowel Surgery ◽  
Pregnancy And Postpartum ◽  
Significant Difference ◽  
Periconceptional Period ◽  
Inflammatory Bowel ◽  
Active Disease

Abstract Background The literature suggests that inflammatory bowel disease (IBD) activity during the periconceptional period is a risk factor for active disease during pregnancy. This study aims to evaluate if there is influence of IBD characteristics (type, classification, duration, activity in the periconceptional period, severity and treatment of disease) on the frequency of active disease during pregnancy and postpartum. Methods Retrospective study that included pregnant women followed in Maternal-Fetal Medicine department at Hospital de Santa Maria diagnosed with IBD, with information on ≥2 of the referred variables and delivery between March 2012 and July 2018 (n = 37; 24 Crohn’s disease, CD and 13 ulcerative colitis, UC). The statistical tests used were chi-square and Fisher’s exact test. Results There was no statistically significant difference between CD and CU in the activity of IBD during pregnancy and postpartum. Diagnosis &gt;5 years and &gt;10 years ago was associated with lower frequency of active disease during pregnancy (15% vs. 78.6%, p &lt; 0.005 and 8.3% vs. 59.1%, p = 0.009, respectively), but did not influence postpartum activity. Age at diagnosis (≤16 years or 17–40 years) did not appear to influence IBD activity. IBD activity during the periconceptional period and pregnancy had a statistically significant association (72.7% with active disease during the periconceptional period and pregnancy and 26.1% with quiescent IBD at the time of conception but active during pregnancy, p = 0.023). There were 3 cases of IBD remission during pregnancy (2 CD and 1 UC). Of the 15 cases of active disease during pregnancy, 6 of them (40%; 4 with CD and 2 with UC) were reactivations. 3 women had active IBD during the postpartum period and all of them already had active disease during pregnancy. Regarding severity, all cases of active IBD were classified as mild disease. The type of therapy (biological, corticosteroids, thiopurines, salicylates, antibiotics or lack of therapy) was not related to disease activity during pregnancy or postpartum. Prior bowel surgery related to IBD (n = 7, all with CD) was associated with a lower frequency of active disease during pregnancy (0% vs. 51.7%, p = 0.027). Conclusion The diagnosis of IBD for more than 5 or 10 years and previous bowel surgery were associated with a lower frequency of active disease during pregnancy. There was a relationship between IBD activity in the periconceptional period and pregnancy, which reinforces the importance of pregnancy planning and prior disease control.

scholarly journals A238 FECAL CALPROTECTIN AND CLINICAL ASSESSMENT TOOLS MAY CORRELATE WITH POOR PREGNANCY-RELATED OUTCOMES IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE

2020 ◽  
Vol 3 (Supplement_1) ◽  
pp. 115-116
Author(s):  
P Tandon ◽  
E Lee ◽  
L Hitz ◽  
C Maxwell ◽  
V Huang
Keyword(s):  
Inflammatory Bowel Disease ◽  
Disease Activity ◽  
Vaginal Delivery ◽  
Bowel Disease ◽  
Congenital Anomalies ◽  
Fecal Calprotectin ◽  
Assessment Tools ◽  
Clinical Scores ◽  
Inflammatory Bowel ◽  
Active Disease

Abstract Background Patients with inflammatory bowel disease (IBD) are at risk of developing adverse pregnancy-related outcomes. Though active disease has been associated with these outcomes, the optimal method of disease assessment in these patients remains unknown. Aims To determine whether clinical and/or objective disease activity correlates with poor maternal and neonatal outcomes in patients with IBD. Methods We retrospectively reviewed the University of Alberta and University of Toronto pregnancy databases to identify patients (age &gt; 18) who underwent routine assessment by a gastroenterologist during any gestational period (first trimester (T1), second trimester (T2), and third trimester (T3). Those with at least one fecal calprotectin (FCP) level during pregnancy were included. Active disease was defined clinically (modified Harvey-Bradshaw Index score ≥ 5 or partial Mayo score ≥ 2) or objectively using stool markeres (FCP ≥ 250 ug/g). Pregnancy-related outcomes (maternal, obstetrical, and neonatal) were recorded from obstetrical records. Low-birth weight (LBW) was defined as an infant weight &lt; 2500g at birth. Continuous variables were reported as medians with interquartile ranges (IQR) and compared with nonparametric Mann-Whitney U and Kruskal-Wallis one-way analysis tests. Categorical variables were compared using the Chi-square (x2) test. Results A total of 85 patients were included. The median FCP in T1 was significantly higher in patients who underwent emergency C-section (503, IQR 1554.3) compared to those who did not (130, IQR 482) (p=0.03). Similarly, the median FCP in T1 was significantly higher in mothers who delivered an infant with LBW (1511, IQR 579) compared to those whose did not (145, IQR 413) (p=0.049). When active disease was defined only by clinical scores, 25% of those with active disease in T1 had a failed vaginal delivery compared to only 2.9% in remission (p=0.027). Similarly, 12.5% of patients with clinically active disease in T1 delivered an infant with congenital anomalies compared to none in clinical remission (p=0.034). When disease activity was defined objectively, those with a FCP &gt; 250 ug/g in T3 were more likely to have an induced vaginal delivery (43.8%) compared to only 14.3% in those in remission (p=0.03). Finally, when disease activity was defined as a combination of clinical scores and FCP &gt; 250 ug/g, those with active disease in T3 had a trend towards an increased risk of induced vaginal delivery (active: 40.0% vs. remission: 17.0%, p=0.064), chorioamnionitis (active: 6.3% vs. remission: 0%, p=0.081) and congenital anomalies (active: 6.3% vs. remission: 0%, p=0.081). Conclusions IBD assessment during pregnancy likely requires a combination of clinical scores and objective markers in order to identify patients at high-risk of developing poor peripartum outcomes. Funding Agencies None

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