P815 Are hospitalised patients with inflammatory bowel disease at increased risk of invasive bacterial infections? Results from POLIBD 2-year cohort study

Abstract Background The disease itself as well as immunomodulatory and biological therapy are risk factors for invasive bacterial infections in patients with inflammatory bowel disease (IBD). However, there are limited data on risk factors for bacteraemia in the general population of hospitalised patients with inflammatory bowel disease. The aim of the study was to assess the rate of bacteraemia in hospitalised patients with Inflammatory Bowel Disease and risk factors. Methods An observational cohort of hospitalised patients with Inflammatory Bowel Disease, aged 23–65 years, from 2017 to 2019 in a large tertiary hospital localised in Rzeszow (south-eastern Poland). Patients with one or more positive blood culture were reviewed. Those with Carlson comorbidity index of 2 or greater were excluded. Basic descriptive statistic and logistic regression to evaluate risk factors for bacteraemia were used. Results Of 727 admitted patients, only 1.24% had bacteraemia (9/727) (8, Crohn’s Disease; 1, Ulcerative Colitis). The most common pathogens were Staphylococcus epidermidis (MRCNS - methicillin-resistant coagulase-negative Staphylococcus - strain resistant to all beta-lactam antibiotics: penicillins, penicillins with a B-lactamase inhibitor, cephalosporin and carbapenem) (4/9 patients) and Escherichia coli (3/9 patients). The mortality rate at 30 days of patients with bacteraemia was 0% (no deaths in IBD patients with bacteraemia observed). Longer hospitalisation (mean length of stay for patients with CD was 42 ± 33 vs. 7.95 ± 17.3, p <0.001; mean length of stay for a patient with UC 15 ± 23 vs. 6.25 ± 15.4, p = 0.004) was associated with an increased risk of bacteraemia. Older age was not associated with an increased risk of bacteraemia (P>0.05). In multivariate analysis, treatment with either anti-tumour necrosis factor α, purine analogues, steroids or amino salicylates was not associated with an increased risk of bacteraemia. Conclusion Prolonged hospitalisation, but not Inflammatory Bowel Disease-related treatment, is associated with an increased risk of bacteraemia in hospitalised patients with Inflammatory Bowel Disease.

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Risk of bacteremia in hospitalised patients with inflammatory bowel disease: a 9-year cohort study

United European Gastroenterology Journal ◽

10.1177/2050640619874524 ◽

2019 ◽

Vol 8 (2) ◽

pp. 195-203

Author(s):

Idan Goren ◽

Adi Brom ◽

Henit Yanai ◽

Amir Dagan ◽

Gad Segal ◽

...

Keyword(s):

Risk Factors ◽

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Bacterial Infections ◽

Tertiary Hospital ◽

Purine Analogues ◽

Hospitalised Patients ◽

Increased Risk ◽

Hospital Patients ◽

Inflammatory Bowel

Background Patients with inflammatory bowel disease might be at increased risk of invasive bacterial infections. Objectives The objective of this study was to identify the rate of bacteremia in hospitalised patients with inflammatory bowel disease and risk factors. Methods An observational cohort of hospitalised patients with inflammatory bowel disease, aged 16–80 years, from 2008 to 2017 in a large tertiary hospital. Patients with Charlson comorbidity index of 2 or greater were excluded. Patients with one or more positive blood culture were reviewed. Logistic regression was used to evaluate risk factors for bacteremia. Results Of 5522 admitted patients, only 1.3% had bacteremia (73/5522) (39, Crohn’s disease; 25, ulcerative colitis; nine, unclassified inflammatory bowel disease). The most common pathogen was Escherichia coli (19/73 patients). The mortality rate at 30 days of patients with bacteremia was 13.7% (10/73). Longer hospitalisations (mean length of stay (21.6 ± 31.0 vs. 6.4 ± 16.0 days; P < 0.0001) and older age (mean age 47.5 ± 18.0 vs. 40.2 ± 15.4 years, P < 0.0001)) were associated with an increased risk of bacteremia. In multivariate analysis, treatment with either anti-tumour necrosis factor α, purine analogues, steroids or amino salicylates was not associated with an increased risk of bacteremia. Risk was greatest among patients aged 65 years or older (relative risk 2.84, 95% confidence interval 1.6–4.8; P = 0.0001) relative to those under 65 years. Conclusion Age over 65 years, but not inflammatory bowel disease-related medications, is associated with an increased risk of bacteremia in hospitalised patients with inflammatory bowel disease.

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Are hospitalized patients with inflammatory bowel disease at increased risk of invasive bacterial infections? Results from POLIBD 3-year cohort study

Gut Pathogens ◽

10.1186/s13099-021-00408-6 ◽

2021 ◽

Vol 13 (1) ◽

Author(s):

Jolanta Gruszecka ◽

Rafał Filip

Keyword(s):

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Staphylococcus Epidermidis ◽

Bacterial Infections ◽

Blood Cultures ◽

Beta Lactam ◽

Beta Lactam Antibiotics ◽

Increased Risk ◽

Inflammatory Bowel ◽

Male Patients

AbstractThe aim of this study was to determine the dominant species of bacteria found in blood cultures collected from patients under treatment in the tertiary inflammatory bowel disease (IBD) center in Poland. The dominant pathogen isolated from blood in patients with IBD was Staphylococcus epidermidis MRCNS (MRCNS—methicillin-resistant coagulase-negative Staphylococcus), a strain resistant to all beta-lactam antibiotics (penicillins, penicillins with B-lactamase inhibitor, cephalosporins and carbapenems). The second most commonly isolated pathogen found in the blood samples was Escherichia coli. Blood cultures were found to be positive for these pathogens more frequently in male patients (90.0%). An increased risk of bacteremia in IBD patients was associated with prolonged hospitalization.

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P012 HOSPITAL RE-ADMISSION IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE – WHAT ARE THE RISK FACTORS?

Inflammatory Bowel Diseases ◽

10.1093/ibd/zaa010.127 ◽

2020 ◽

Vol 26 (Supplement_1) ◽

pp. S50-S50

Author(s):

Rajan Patel ◽

Renate Fromson ◽

Emma Routledge ◽

Emma Johnson ◽

Sina Jameie-Oskooei ◽

...

Keyword(s):

Risk Factors ◽

Inflammatory Bowel Disease ◽

Logistic Regression ◽

Length Of Stay ◽

Bowel Disease ◽

Admission Rate ◽

Clinical Environment ◽

Multivariate Logistic Regression ◽

Increased Risk ◽

Inflammatory Bowel

Abstract Introduction Early re-admission after hospitalisation for an inflammatory bowel disease (IBD) flare is a negative quality indicator and causes unnecessary healthcare expense. Scoring systems to predict IBD readmissions have been shown to be ineffective. We aimed to describe the IBD re-admission rate at our hospital and investigate the risk factors. Methods Retrospective study of patients admitted to a London-based district general hospital under the gastroenterology team with a flare of inflammatory bowel disease between 2015 and 2018. Characteristic including but not limited to demographics, disease type, length of stay during index admission, biochemistry and biologic use were recorded. Hospital software (Sunquest Integrated Clinical Environment, Medway) was used to identify patients re-admitted at 30 and 90 days after discharge. Multivariate logistic regression was performed. Results 138 patients were admitted with an IBD flare during the study period (74 (53.6%) Crohn’s disease (CD), 56 (40.6%) ulcerative colitis (UC), 8 (5.8%) IBD-U). Median age 33.5 (IQR 26 – 52), 71 (51.4%) female. Median length of stay was 4.5 days (IQR 1.8 – 8). 36 (26%) patients were taking a biologic. Re-admissions occurred within 30 days in 19 patients (13.7%) and within 90 days in 30 patients (21.7%). Multivariate logistic regression showed that a raised CRP on discharge was associated with re-admission. For every increased unit of CRP by one there was an increased risk of readmission by 1.1 times (p=0.05). Patients aged 22–39 were significantly less likely to be readmitted (OR: 0.38, p=0.015). Male patients were significantly more likely to be readmitted (OR: 2.52, p=0.05). Conclusion The 30 day and 90 day re-admission rate for our IBD population is just over 10% and 20%, respectively. CRP at discharge is significantly associated with both 30 and 90 day re-admission. After adjusting for confounders; CRP, age older than 40 and male gender were associated with re-admission to hospital. We advise caution in discharging IBD patients with raised inflammatory markers. Close follow up within a few days of discharge would be appropriate in this high risk sub-group.

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Laryngeal Carcinoma in Patients With Inflammatory Bowel Disease: Clinical Outcomes and Risk Factors

Inflammatory Bowel Diseases ◽

10.1093/ibd/izz210 ◽

2019 ◽

Vol 26 (7) ◽

pp. 1060-1067

Author(s):

Steffi E M van de Ven ◽

Lauranne A A P Derikx ◽

Iris D Nagtegaal ◽

Carla M van Herpen ◽

Robert P Takes ◽

...

Keyword(s):

Risk Factors ◽

Inflammatory Bowel Disease ◽

Risk Factor ◽

Bowel Disease ◽

Case Control Studies ◽

Transplant Patients ◽

Immunosuppressive Medication ◽

Survival Difference ◽

Increased Risk ◽

Inflammatory Bowel

Abstract Background Inflammatory bowel disease (IBD) patients are at increased risk for developing extra-intestinal malignancies, mainly due to immunosuppressive medication. The risk of developing head and neck cancer in immunosuppressed transplant patients is increased. The relation between IBD patients and laryngeal cancer (LC) remains unclear. We aimed (1) to identify risk factors in IBD patients for LC development and (2) to compare clinical characteristics, outcome, and survival of LC in IBD patients with the general population. Methods All IBD patients with LC (1993–2011) were retrospectively identified using the Dutch Pathology Database. We performed 2 case–control studies: (1) to identify risk factors, we compared patients with IBD and LC (cases) with the general IBD population; (2) to analyze LC survival, we compared cases with controls from the general LC population. Results We included 55 cases, 1800 IBD controls, and 2018 LC controls. Cases were more frequently male compared with IBD controls (P < 0.001). For ulcerative colitis (UC), cases were older at IBD diagnosis (P < 0.001). Crohn’s disease (CD) cases were more frequently tobacco users (P < 0.001) and more often had stricturing (P = 0.006) and penetrating (P = 0.008) disease. We found no survival difference. Immunosuppressive medication had no impact on survival. Conclusions Male sex was a risk factor for LC in IBD patients. Older age at IBD diagnosis was a risk factor for UC to develop LC. Tobacco use and stricturing and penetrating disease were risk factors for LC development in CD patients. Inflammatory bowel disease was not associated with impaired survival of LC. Immunosuppressive medication had no influence on survival.

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Biologic-Induced Infections in Inflammatory Bowel Disease: The TNF-α Antagonists

Annals of Pharmacotherapy ◽

10.1177/1060028018754896 ◽

2018 ◽

Vol 52 (6) ◽

pp. 571-579 ◽

Cited By ~ 4

Author(s):

Sean M. McConachie ◽

Sheila M. Wilhelm ◽

Ashish Bhargava ◽

Pramodini B. Kale-Pradhan

Keyword(s):

Risk Factors ◽

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Opportunistic Infections ◽

Case Series ◽

Infectious Risk ◽

Increased Risk ◽

Tnf Α ◽

Inflammatory Bowel ◽

Meta Analyses

Objective: To review the mechanism and association of infectious risk among the tumor-necrosis factor α (TNF-α) antagonists used in inflammatory bowel disease. Data Sources: A PubMed literature search was performed using the following search terms: infliximab, adalimumab, certolizumab, golimumab, inflammatory bowel disease, crohn’s, ulcerative colitis, adverse effects, adverse events, safety, and infection. Study Selection and Data Extraction: Meta-analyses and cohort studies with outcomes pertaining to quantitative infectious risk were reviewed. Case reports and case series describing association between TNF-α inhibitors and infection were also reviewed. Data Synthesis: A total of 7 recent meta-analyses of randomized trials demonstrate inconclusive association of infection with TNF-α antagonists. Registry data suggest that medications carry an independent risk of opportunistic infections. Risk factors for infection include older age, malnutrition, diabetes, and possibly combination therapy. Reported infections vary widely but include intracellular and granulomatous bacteria, viruses, and fungi. Conclusion: TNF-α antagonists are associated with an increased risk of opportunistic infection, although this risk has not been demonstrated conclusively in randomized controlled trials. Knowledge of concomitant risk factors, mechanism of infectious risk, and available treatment options can improve patient care in the clinical setting.

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Inflammatory bowel disease and cardiovascular diseases: a concise review

European Heart Journal Open ◽

10.1093/ehjopen/oeab029 ◽

2021 ◽

Author(s):

Hao Wu ◽

Tingzi Hu ◽

Hong Hao ◽

Michael A Hill ◽

Canxia Xu ◽

...

Keyword(s):

Risk Factors ◽

Inflammatory Bowel Disease ◽

Cardiovascular Diseases ◽

Inflammatory Cytokines ◽

Bowel Disease ◽

Bleeding Risk ◽

Team Approach ◽

Increased Risk ◽

Inflammatory Bowel ◽

Traditional Risk Factors

Abstract Cardiovascular diseases (CVDs) remain the leading cause of morbidity and mortality despite aggressive treatment of traditional risk factors. Chronic inflammation plays an important role in the initiation and progression of CVDs. Inflammatory bowel disease (IBD) is a systemic state of inflammation exhibiting increased levels of pro-inflammatory cytokines including tumor necrosis factor-α, interleukin (IL)-1β, and IL-6. Importantly, IBD is associated with increased risk for CVDs especially in women and young adults, including coronary artery disease, stroke, thromboembolic diseases, and arrhythmias. Potential mechanisms underlying the increased risk for CVDs in IBD patients include increased levels of inflammatory cytokines and oxidative stress, altered platelet function, hypercoagulability, decreased numbers of circulating endothelial progenitor cells, endothelial dysfunction, and possible interruption of gut microbiota. Although IBD does not appear to exacerbate the traditional risk factors for CVDs, including hypertension, hyperlipidemia, diabetes mellitus, and obesity, aggressive risk stratifications are important for primary and secondary prevention of CVDs for IBD patients. Compared to 5-ASA and corticosteroids, anti-TNF-α therapy in IBD patients was consistently associated with decreasing cardiovascular events. In the absence of contraindications, low-dose aspirin and statins appear to be beneficial for IBD patients. Low-molecular-weight heparin is also recommended for patients who are hospitalized with acute IBD flares without major bleeding risk. A multidisciplinary team approach should be considered for the management of IBD patients.

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P626 SARS-CoV-2 seroprevalence in patients with Inflammatory Bowel Disease

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjab076.746 ◽

2021 ◽

Vol 15 (Supplement_1) ◽

pp. S564-S564

Author(s):

S García Mateo ◽

S J Martínez-Domínguez ◽

M C Aso Gonzalvo ◽

C J Gargallo-Puyuelo ◽

B Gallego Llera ◽

...

Keyword(s):

Risk Factors ◽

Inflammatory Bowel Disease ◽

Potential Risk ◽

Bowel Disease ◽

Biologic Agents ◽

World Health ◽

Indeterminate Colitis ◽

Increased Risk ◽

Potential Risk Factors ◽

Inflammatory Bowel

Abstract Background Patients with Inflammatory Bowel Disease (IBD) suffer from a chronic illness and many of them need immunosuppressive therapy throughout the course of the disease. Consequently, COVID-19 pandemic has caused uncertainty about the possible increased risk of suffering SARS-CoV-2 infection that could confer IBD or its treatments. The aim of this study is to assess SARS-CoV-2 seroprevalence in patients with IBD as well as the existence of potential risk factors for its development. Methods This is a unicentric cross-sectional study developed in IBD unit of University Hospital “Lozano Blesa” of Zaragoza. Patients older than 18 years with established diagnosis of Crohn′s Disease (CD), Ulcerative Colitis (UC) or Indeterminate Colitis (IC) have been included. A blood sample has been drawn from each patient to detect IgG against SARS-CoV-2 (ELISA method) and each patient has completed a questionnaire to know symptoms related to infection and previous comorbidity. We have performed a descriptive analysis and a univariate analysis to study relationship between potential risk factors and seroconversion against SARS-CoV-2. Results 431 patients have been included, with a mean age of 50.2 ± 14.1 years and a 51.3% of women. Of them, 49.7% suffer from UC, 49.2% CD and 1.2% IC. Related to the treatment, 23.5% receive anti-TNF biologic agents, 13.1% other kind of biologic agents, 9.3% immunomodulators, 7.7% combined treatment (biologic agent and immunomodulator), 33.1% other treatment and 13.3% no treatment. According to World Health Organization (WHO) definitions, 85.6% had not suffered the infection, 7.7% were confirmed cases (only 3 admitted patients) and 6.7% were probable cases. The seroprevalence of SARS-CoV-2 obtained is 8.8%, being significantly higher among confirmed cases than among probable cases (71.0% in confirmed vs 6.9% in probable; RR 10.3; p<0.001). A higher risk of seroconversion has been detected among patients without biologic agents (11.8% in patients without biologic agents vs 5.3% in patients with biologic agents; RR 2.2; p=0.021). No differences have been observed in the seroprevalence of patients with other treatments for IBD or in terms of age, active smoking, level of inflammation markers, the presence of symptoms of infection or hospital admission. Conclusion The seroprevalence of SARS-CoV-2 of Aragon′s patients with IBD is similar to that described in national seroprevalence study of Ministry of Health for the region (8.8%). The treatment with biologic agents is associated with a lower risk of seroconversion

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P6391Major acute cardiovascular events in patients with inflammatory bowel disease

European Heart Journal ◽

10.1093/eurheartj/ehz746.0987 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

G Gill ◽

S Fernandez ◽

M Soud ◽

M Mete ◽

N Malhotra ◽

...

Keyword(s):

Risk Factors ◽

Myocardial Infarction ◽

Inflammatory Bowel Disease ◽

Heart Disease ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Bowel Disease ◽

Increased Risk ◽

All Cause Mortality ◽

Inflammatory Bowel

Abstract Introduction Traditional risk factors for coronary heart disease have been reported in around 85% patients who present with myocardial infarction. More recently, inflammation and immune mediated diseases have been associated with ischemic heart disease. Inflammatory Bowel Disease (IBD) is an immune mediated disorder which comprises of ulcerative colitis and Crohn's disease. Estimated prevalence of IBD in the United States in 2004 was 1.4 million people. These patients have an overall increased risk of thrombotic complications with microvascular thrombosis hypothesized to contribute in disease pathogenesis. Results from a recent meta-analysis were consistent with increased risk of ischemic heart disease among IBD patients, with risk greater in females and younger patients, although heterogeneity was considerable in overall data. Also, in a recent study, IBD was found to be associated with an increased risk of acute myocardial infarction and heart failure despite lower prevalence of coronary risk factors in IBD patients. IBD pathogenesis involves sustained activation of immune responses with upregulation of cytokines including but not limited to IL-1 beta, IL-6 and TNF-alpha. Upregulation of these cytokines has also been reported in coronary atherosclerosis. Based on above information, we explored incidence of MACE (Major Adverse Cardiac Event) in this patient population from our health system data-base. Methods Propensity scores were estimated for all 15,292 (0.4%) patients with inflammatory bowel disease from a total patient pool of 3,917,894 patients in our health system to assemble a 1:1 matched cohort balanced for age, gender, race and known cardiovascular risk factors including hypertension, hyperlipidemia, diabetes mellitus and smoking (current and former). ICD-9 and ICD-10 codes were used to identify cardiovascular risk factors and outcomes. Results Matched patients (n=30,584) had a mean age of 51 years, with 58% of all being women, and 63% Caucasian. During the median follow up of 4.4 years all-cause mortality was observed in 1.7% and 1.2% of patients from IBD and non-IBD groups respectively (hazard ratio {HR}, 1.31; 95% confidence interval {CI}, 1.08–1.58; p=0.005). Combined outcome for myocardial infarction or all-cause mortality was noted in 4.1% and 3.4% from IBD and non-IBD groups respectively (HR, 1.16; 95% CI, 1.03–1.30; p=0.014) while HRs for cardiovascular mortality, myocardial infarction and unstable angina independently were 1.04 (0.74–1.47; p=0.833), 1.05 (0.89–1.23; p=0.591) and 1.10 (0.83–1.46; p=0.524) respectively. Conclusion Inflammatory bowel disease did not show association with myocardial infarction, cardiovascular mortality or unstable angina when matched for known cardiovascular risk factors, but was associated with increased all-cause mortality and combined end-point of all-cause mortality or myocardial infarction.

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Predicting the development of psychological morbidity in inflammatory bowel disease: a systematic review

Frontline Gastroenterology ◽

10.1136/flgastro-2019-101353 ◽

2020 ◽

pp. flgastro-2019-101353

Author(s):

Anna B Hoogkamer ◽

Alenka J Brooks ◽

Georgina Rowse ◽

Alan J Lobo

Keyword(s):

Risk Factors ◽

Inflammatory Bowel Disease ◽

Bowel Disease ◽

English Language ◽

Psychological Morbidity ◽

Physical Factors ◽

Increased Risk ◽

Comorbidity Burden ◽

Inflammatory Bowel ◽

The Impact

BackgroundPsychological morbidity in inflammatory bowel disease is common with significant impact on quality of life and health outcomes, but factors which predict the development of psychological morbidity are unclear.AimTo undertake a systematic literature review of the predictors of psychological morbidity in patients with inflammatory bowel disease.MethodsElectronic searches for English-language articles were performed with keywords relating to psychological morbidity according to the Diagnostic and Statistical Manual of Mental Disorders IV and subsequent criteria, and inflammatory bowel disease; in MEDLINE, PsychInfo, Web of Science and EMBASE for studies published from January 1997 to 25 January 2019.ResultsOf 660 studies identified, seven met the inclusion criteria. All measured depression, with three also measuring anxiety. Follow-up duration was variable (median of 18 months range 6–96 months). Risk factors identified for development of psychological morbidity included physical factors: aggressive disease (HR 5.77, 95% CI 1.89 to 17.7) and greater comorbidity burden (OR 4.31, 95% CI 2.83 to 6.57) and psychological risk factors: degree of gratitude (r=−0.43, p<0.01) and parenting stress (R-change=0.03, F(1,58)=35.6, p<0.05). Age-specific risk was identified with young people (13–17 years) at increased risk.ConclusionsIdentifiable risks for the development of psychological morbidity in inflammatory bowel disease include physical and psychological factors. Further research is required from large prospective studies to enable early interventions in those at risk and reduce the impact of psychological morbidity.

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A220 A COMPREHENSIVE SYSTEMATIC REVIEW AND META-ANALYSIS OF THE RISK OF ADVERSE NEONATAL OUTCOME IN INFLAMMATORY BOWEL DISEASE AND PREGNANCY

Journal of the Canadian Association of Gastroenterology ◽

10.1093/jcag/gwz047.219 ◽

2020 ◽

Vol 3 (Supplement_1) ◽

pp. 94-95

Author(s):

K Leung ◽

P Tandon ◽

V Govardhanam ◽

C Maxwell ◽

V Huang

Keyword(s):

Risk Factors ◽

Inflammatory Bowel Disease ◽

Preterm Birth ◽

Bowel Disease ◽

Neonatal Outcomes ◽

Healthy Controls ◽

Increased Risk ◽

Adverse Neonatal Outcomes ◽

Inflammatory Bowel ◽

Active Disease

Abstract Background Inflammatory bowel disease (IBD) often affects women in their child-bearing years. These women may be at an increased risk of adverse neonatal outcomes. Aims The aim of this study was to evaluate the risk of these outcomes in this population of patients, with an emphasis of determining risk factors for development of these conditions. Methods Medline, Embase, and Cochrane library were searched through to May 2019 for studies reporting adverse neonatal outcomes in IBD patients. Weighted odds ratios (OR) with 95% confidence intervals (CI) were calculated to assess the risk of these outcomes in patients with IBD compared to healthy controls, with risk factors such as disease activity and medication exposure also being assessed. Results Sixty studies were included (8194 pregnancies with inflammatory bowel disease and 3253 healthy pregnancies). Compared to healthy controls, patients with inflammatory bowel disease were more likely to deliver infants with low birth weight (LBW) (OR 2.78, 95% CI 1.16–6.66) and infants who were admitted to the neonatal intensive care unit (NICU) (OR 3.33, 95% CI 1.83–6.05). Patients with Crohn’s disease had an increased risk of infants born with congenital anomalies (OR 3.03, 95% CI, 1.43–6.42), whereas patients with ulcerative colitis had an increased risk of preterm delivery (OR 2.68, 95% CI, 1.12–6.43). Active disease increased the risk of preterm birth (OR 2.06, 95% CI 1.21–3.51), LBW (OR 2.96, 95% CI 1.54–5.70), and small for gestation age (OR 2.62, 95% CI 1.18–5.83) compared to disease in remission. Tumor necrosis factor antagonists was associated with increased risk of NICU admission (OR 2.42, 95% CI 1.31–4.45) and LBW (OR 1.54, 95% CI, 1.01–2.35). Conclusions Patients with inflammatory bowel disease are at an increased risk of developing adverse neonatal outcomes such as preterm birth, LBW, congenital anomalies, and NICU admissions. Patients with clinically active disease and those exposed to anti-TNF therapy may be at higher risk of developing these adverse outcomes. The findings of this study are important to communicate to patients and healthcare providers alike. Furthermore, this information may help to mitigate these risks through collaborative specialized care during pregnancy in order to reduce the overall morbidity and mortality for both mother and baby. Funding Agencies None

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