Incidence and Predictors of Flares in the Postpartum Year Among Women With Inflammatory Bowel Disease.


BACKGROUND:The postpartum period is marked by physiological and psychological stresses that may impact activity in inflammatory bowel disease. The predictors and outcomes of disease activity during this period have not been well characterized. METHODS:We performed a retrospective review of inflammatory bowel disease patients who underwent successful pregnancy and live birth at 2 referral institutions. Data on patient and disease factors including disease activity before and during pregnancy were abstracted from the medical records. We noted whether therapy was dose-reduced or stopped during pregnancy at each trimester and after delivery. Multivariable logistic regression of independent predictors of postpartum flare was performed, adjusting for relevant covariates. RESULTS:We identified a total of 206 eligible women (mean age, 33.2 years). Of these, 97 (47%) had a diagnosis of Crohn's disease, whereas the remainder had ulcerative colitis. Nearly half the women delivered vaginally (53%), and the rest delivered by Caesarean section (47%). In the entire cohort, 65 (31.6%) experienced a postpartum flare within the year after delivery. In multivariable analysis, development of a postpartum flare was predicted by disease activity during the third trimester (odds ratio [OR], 6.27; 95% confidence interval [CI], 2.81-17.27), therapy de-escalation during pregnancy (OR, 3.00; 95% CI, 1.03-8.68), and therapy de-escalation after pregnancy (OR, 4.43; 95% CI, 1.55-12.65). Postpartum disease flare was not related to disease type, duration of disease, or mode of childbirth. CONCLUSIONS:One-third of women with inflammatory bowel disease may experience disease flare during the postpartum year. Continued optimization of therapy before, during, and after pregnancy is essential to prevent this morbidity.


Inflamm Bowel Dis


Yu A,Friedman S,Ananthakrishnan AN




Has Abstract


2020-11-19 00:00:00














  • Metronidazole or Rifaximin for Treatment of Clostridium difficile in Pediatric Patients with Inflammatory Bowel Disease: A Randomized Clinical Trial.

    abstract:BACKGROUND:Interestingly, Clostridium difficile infection (CDI) worsens the course of inflammatory bowel disease (IBD); however, there is a paucity of data regarding the treatment of CDI in this group of patients. METHODS:This was a prospective, single-blind trial. Children with flare of IBD and CDI were randomly assi...

    journal_title:Inflammatory bowel diseases

    pub_type: 杂志文章,随机对照试验


    authors: Gawronska A,Banasiuk M,Lachowicz D,Pituch H,Albrecht P,Banaszkiewicz A

    更新日期:2017-12-01 00:00:00

  • Overexpression of miR-595 and miR-1246 in the sera of patients with active forms of inflammatory bowel disease.

    abstract:BACKGROUND:MicroRNAs (miRNAs) are dysregulated in the inflammatory bowel diseases, Crohn's disease (CD) and ulcerative colitis (UC), which arise due to dysfunctional host-microbe interactions and impairment of the barrier function of the intestine. Here, we sought to determine whether circulating miRNAs are biomarkers ...

    journal_title:Inflammatory bowel diseases

    pub_type: 杂志文章


    authors: Krissansen GW,Yang Y,McQueen FM,Leung E,Peek D,Chan YC,Print C,Dalbeth N,Williams M,Fraser AG

    更新日期:2015-03-01 00:00:00

  • G Protein-coupled pH-sensing Receptor OGR1 Is a Regulator of Intestinal Inflammation.

    abstract:BACKGROUND:A novel family of proton-sensing G protein-coupled receptors, including OGR1, GPR4, and TDAG8, was identified to be important for physiological pH homeostasis and inflammation. Thus, we determined the function of proton-sensing OGR1 in the intestinal mucosa. MTEHODS:OGR1 expression in colonic tissues was in...

    journal_title:Inflammatory bowel diseases

    pub_type: 杂志文章


    authors: de Vallière C,Wang Y,Eloranta JJ,Vidal S,Clay I,Spalinger MR,Tcymbarevich I,Terhalle A,Ludwig MG,Suply T,Fried M,Kullak-Ublick GA,Frey-Wagner I,Scharl M,Seuwen K,Wagner CA,Rogler G

    更新日期:2015-06-01 00:00:00

  • Validation of the PHQ-9 for Suicidal Ideation in Persons with Inflammatory Bowel Disease.

    abstract:Background:Suicide is a leading cause of death worldwide. Transition from suicidal ideation (SI) to suicide attempt is high within a year of SI onset. The risk of suicide and SI is elevated in persons with inflammatory bowel disease (IBD) versus the general population. We aimed to validate the Patient Heath Questionnai...

    journal_title:Inflammatory bowel diseases

    pub_type: 杂志文章


    authors: Litster B,Bernstein CN,Graff LA,Walker JR,Fisk JD,Patten SB,Bolton JM,Sareen J,El-Gabalawy R,Marrie RA

    更新日期:2018-07-12 00:00:00

  • Genome-wide association scans identify multiple confirmed susceptibility loci for Crohn's disease: lessons for study design.

    abstract::The last 12 months have seen unprecedented progress in identifying the susceptibility genes that predispose to common disease in general and Crohn's disease in particular. Success has derived from the new technique of genome-wide association scanning in large panels of cases and controls. This has itself been made pos...

    journal_title:Inflammatory bowel diseases

    pub_type: 杂志文章,评审


    authors: Tremelling M,Parkes M

    更新日期:2007-12-01 00:00:00

  • Muc5ac Expression Protects the Colonic Barrier in Experimental Colitis.

    abstract:BACKGROUND:The mucus gel layer (MGL) lining the colon is integral to exclusion of bacteria and maintaining intestinal homeostasis in health and disease. Some MGL defects allowing bacteria to directly contact the colonic surface are commonly observed in ulcerative colitis (UC). The major macromolecular component of the ...

    journal_title:Inflammatory bowel diseases

    pub_type: 杂志文章


    authors: Olli KE,Rapp C,O'Connell L,Collins CB,McNamee EN,Jensen O,Jedlicka P,Allison KC,Goldberg MS,Gerich ME,Frank DN,Ir D,Robertson CE,Evans CM,Aherne CM

    更新日期:2020-08-20 00:00:00

  • Assessing the Optimal Position for Vedolizumab in the Treatment of Ulcerative Colitis: A Simulation Model.

    abstract:Background:Vedolizumab, an α4β7 integrin monoclonal antibody inhibiting gut lymphocyte trafficking, is an effective treatment for ulcerative colitis (UC). We evaluated the optimal position of vedolizumab in the UC treatment paradigm. Methods:Using Markov modeling, we assessed multiple algorithms for the treatment of U...

    journal_title:Inflammatory bowel diseases

    pub_type: 杂志文章


    authors: Scott FI,Shah Y,Lasch K,Luo M,Lewis JD

    更新日期:2018-01-18 00:00:00

  • Two-stage genome-wide methylation profiling in childhood-onset Crohn's Disease implicates epigenetic alterations at the VMP1/MIR21 and HLA loci.

    abstract:BACKGROUND:As a result of technological and analytical advances, genome-wide characterization of key epigenetic alterations is now feasible in complex diseases. We hypothesized that this may provide important insights into gene-environmental interactions in Crohn's disease (CD) and is especially pertinent to early onse...

    journal_title:Inflammatory bowel diseases

    pub_type: 杂志文章


    authors: Adams AT,Kennedy NA,Hansen R,Ventham NT,OʼLeary KR,Drummond HE,Noble CL,El-Omar E,Russell RK,Wilson DC,Nimmo ER,Hold GL,Satsangi J

    更新日期:2014-10-01 00:00:00

  • Endoscopic and chromoendoscopic atlas featuring dysplastic lesions in surveillance colonoscopy for patients with long-standing ulcerative colitis.

    abstract::Clinical and epidemiological studies have revealed that the incidence of colorectal cancer associated with ulcerative colitis increases with long-term chronic inflammation. Careful endoscopic observation and histological studies to check for dysplasia in the colon are important in detecting neoplasia. Current surveill...

    journal_title:Inflammatory bowel diseases

    pub_type: 杂志文章,评审


    authors: Matsumoto T,Iwao Y,Igarashi M,Watanabe K,Otsuka K,Watanabe T,Iizuka B,Hida N,Sada M,Chiba T,Kudo SE,Oshitani N,Nagawa H,Ajioka Y,Hibi T

    更新日期:2008-02-01 00:00:00

  • Murine TNF(DeltaARE) Crohn's disease model displays diminished expression of intestinal Ca2+ transporters.

    abstract:BACKGROUND:Patients suffering from Crohn's disease (CD) show increased incidence of low bone mineral density. Investigating this complication is difficult because the exact etiology of CD remains elusive. Mice carrying a deletion in the tumor necrosis factor (TNF) AU-rich elements (ARE) are reported as a model for huma...

    journal_title:Inflammatory bowel diseases

    pub_type: 杂志文章


    authors: Huybers S,Apostolaki M,van der Eerden BC,Kollias G,Naber TH,Bindels RJ,Hoenderop JG

    更新日期:2008-06-01 00:00:00

  • Multidimensional Impact of Mediterranean Diet on IBD Patients.

    abstract:BACKGROUND & AIMS:Malnutrition with the accumulation of fat tissue and nonalcoholic fatty liver disease (NAFLD) are conditions associated with inflammatory bowel disease (IBD). Visceral fat and NAFLD-related liver dysfunction can both worsen intestinal inflammation. Because the Mediterranean diet (Md) has been shown to...

    journal_title:Inflammatory bowel diseases

    pub_type: 杂志文章


    authors: Chicco F,Magrì S,Cingolani A,Paduano D,Pesenti M,Zara F,Tumbarello F,Urru E,Melis A,Casula L,Fantini MC,Usai P

    更新日期:2021-01-01 00:00:00

  • Regulation of gene expression in inflammatory bowel disease and correlation with IBD drugs: screening by DNA microarrays.

    abstract::Potential biomarkers for Crohn's disease (CD) and ulcerative colitis (UC) were identified from two sets of full thickness pathologic samples utilizing DermArray and PharmArray DNA microarrays relative to uninvolved (Un) colon or normal colon. Seven of the over-expressed genes were verified using quantitative RT-PCR (i...

    journal_title:Inflammatory bowel diseases

    pub_type: 杂志文章


    authors: Dooley TP,Curto EV,Reddy SP,Davis RL,Lambert GW,Wilborn TW,Elson CO

    更新日期:2004-01-01 00:00:00

  • Atherogenic diets exacerbate colitis in mice deficient in glutathione peroxidase.

    abstract:BACKGROUND:The proinflammatory effect of high-fat diet has been observed beyond the cardiovascular system, but there is little evidence to support its role in triggering inflammatory bowel disease. GPx1/2-double-knockout (DKO) mice deficient in 2 intracellular glutathione peroxidases, GPx1 and GPx2, on a C57BL/6 (B6) b...

    journal_title:Inflammatory bowel diseases

    pub_type: 杂志文章


    authors: Gao Q,Esworthy RS,Kim BW,Synold TW,Smith DD,Chu FF

    更新日期:2010-12-01 00:00:00

  • INSPIRE study: does stress management improve the course of inflammatory bowel disease and disease-specific quality of life in distressed patients with ulcerative colitis or Crohn's disease? A randomized controlled trial.

    abstract:BACKGROUND:The use of stress management psychotherapy is hypothesized to produce greater improvement in disease course and disease-specific quality of life (IBDQ) compared to usual medical care alone in patients with ulcerative colitis (UC) or Crohn's disease (CD) showing high levels of stress (based on the Perceived S...

    journal_title:Inflammatory bowel diseases

    pub_type: 杂志文章,随机对照试验


    authors: Boye B,Lundin KE,Jantschek G,Leganger S,Mokleby K,Tangen T,Jantschek I,Pripp AH,Wojniusz S,Dahlstroem A,Rivenes AC,Benninghoven D,Hausken T,Roseth A,Kunzendorf S,Wilhelmsen I,Sharpe M,Blomhoff S,Malt UF,Jahnsen J

    更新日期:2011-09-01 00:00:00

  • Evaluation of Crohn's Disease Activity: Development of an Ultrasound Score in a Multicenter Study.

    abstract:OBJECTIVE:Our goal in this multicentric prospective study was 2-fold: first, to test the diagnostic accuracy of ultrasound, color Doppler imaging (CDI), and contrast-enhanced ultrasound (CEUS) in identifying disease activity in patients with Crohn's disease (CD) compared with endoscopy as the reference standard; and, s...

    journal_title:Inflammatory bowel diseases

    pub_type: 杂志文章


    authors: Ripollés T,Poza J,Suarez Ferrer C,Martínez-Pérez MJ,Martín-Algíbez A,de Las Heras Paez B

    更新日期:2021-01-01 00:00:00

  • Predictors of quality of life in ulcerative colitis: the importance of symptoms and illness representations.

    abstract:BACKGROUND:Establishing predictors of quality of life (QoL) in individuals with inflammatory bowel disease could help to identify those patients who are most likely to experience poor QoL and to target therapeutic interventions appropriately. We aimed to investigate how disease-specific QoL depends on demographic, dise...

    journal_title:Inflammatory bowel diseases

    pub_type: 杂志文章


    authors: Han SW,McColl E,Barton JR,James P,Steen IN,Welfare MR

    更新日期:2005-01-01 00:00:00

  • Real-time Interobserver Agreement in Bowel Ultrasonography for Diagnostic Assessment in Patients With Crohn's Disease: An International Multicenter Study.

    abstract:BACKGROUND:The unavailability of standardized parameters in bowel ultrasonography (US) commonly used in Crohn's disease (CD) and the shortage of skilled ultrasonographers are 2 limiting factors in the use of this imaging modality around the world. The aim of this study is to evaluate interobserver agreement among exper...

    journal_title:Inflammatory bowel diseases

    pub_type: 杂志文章,多中心研究


    authors: Calabrese E,Kucharzik T,Maaser C,Maconi G,Strobel D,Wilson SR,Zorzi F,Novak KL,Bruining DH,Iacucci M,Watanabe M,Lolli E,Chiaramonte C,Hanauer SB,Panaccione R,Pallone F,Ghosh S,Monteleone G

    更新日期:2018-08-16 00:00:00

  • Totally laparoscopic total proctocolectomy: a safe alternative to open surgery in inflammatory bowel disease.

    abstract:BACKGROUND:Inflammatory bowel disease (IBD) patients have a high incidence of wound and overall postoperative complications. A totally laparoscopic approach could potentially reduce these risks. We adopted totally laparoscopic total proctocolectomy (TL-TPC) using the perineal wound for extraction as the procedure of ch...

    journal_title:Inflammatory bowel diseases

    pub_type: 杂志文章


    authors: Holder-Murray J,Zoccali M,Hurst RD,Umanskiy K,Rubin M,Fichera A

    更新日期:2012-05-01 00:00:00

  • Thromboembolism in pediatric inflammatory bowel disease: systematic review.

    abstract:BACKGROUND:Several studies suggest an increased risk of venous and arterial thromboembolism (TE) in adults with inflammatory bowel disease (IBD) compared to the general population. We performed a systematic review of studies on incidence and characteristic of TE in children with IBD. METHODS:We searched Medline, LILAC...

    journal_title:Inflammatory bowel diseases

    pub_type: 杂志文章,评审


    authors: Lazzerini M,Bramuzzo M,Maschio M,Martelossi S,Ventura A

    更新日期:2011-10-01 00:00:00

  • Segmental Resection versus Total Proctocolectomy for Crohn's Colitis: What is the Best Operation in the Setting of Medically Refractory Disease or Dysplasia?

    abstract::Crohn's disease (CD) may affect any part of the gastrointestinal tract. When isolated to the colon, and patients become medically refractory, there are several surgical options - segmental resection, subtotal colectomy with ileorectal anastomosis, or a total proctocolectomy and end ileostomy. Unfortunately, surgery do...

    journal_title:Inflammatory bowel diseases

    pub_type: 杂志文章,评审


    authors: Lightner AL

    更新日期:2018-02-15 00:00:00

  • Successful treatment of an acute flare of steroid-resistant Crohn's colitis during pregnancy with unfractionated heparin.

    abstract::Recent reports suggest that unfractionated heparin may be a useful adjunct in the treatment of inflammatory bowel disease (IBD). We report the successful use of subcutaneous unfractionated heparin to treat a moderate-to-severe flare of Crohn's disease during pregnancy, which was refractory to standard therapy. The pat...

    journal_title:Inflammatory bowel diseases

    pub_type: 杂志文章


    authors: Prajapati DN,Newcomer JR,Emmons J,Abu-Hajir M,Binion DG

    更新日期:2002-05-01 00:00:00

  • Fecal Calprotectin Predicts Relapse and Histological Mucosal Healing in Ulcerative Colitis.

    abstract:BACKGROUND:Mucosal healing in ulcerative colitis leads to a decreased need for medication and decreased risk of disease relapse and colectomy. Histological healing seems to improve the disease prognosis even further. An assessment of both endoscopic and histological mucosal healing requires endoscopy, and the need for ...

    journal_title:Inflammatory bowel diseases

    pub_type: 杂志文章


    authors: Theede K,Holck S,Ibsen P,Kallemose T,Nordgaard-Lassen I,Nielsen AM

    更新日期:2016-05-01 00:00:00

  • MicroRNAs in inflammatory bowel diseases: paradoxes and possibilities.

    abstract::MicroRNAs (miRNAs) are single-stranded RNA molecules, which influence the translation of messenger RNA and hence protein synthesis. The altered expression of miRNAs in disease states in cancer and autoimmune diseases including inflammatory bowel disease is providing new insights into disease pathogenesis. This underst...

    journal_title:Inflammatory bowel diseases

    pub_type: 杂志文章,评审


    authors: Whiteoak SR,Felwick R,Sanchez-Elsner T,Fraser Cummings JR

    更新日期:2015-05-01 00:00:00

  • Outcomes of Perianal Fistulising Crohn's Disease Following Anti-TNFα Treatment Discontinuation.

    abstract:Background:Discontinuation of antitumour necrosis factor (TNF)α therapy with perianal fistulising Crohn's disease remains controversial due to the risk of severe relapse without any clear evidence. Aim:The aim of this study was to assess the rate and type of perianal and luminal relapses following anti-TNFα discontinu...

    journal_title:Inflammatory bowel diseases

    pub_type: 杂志文章


    authors: Legué C,Brochard C,Bessi G,Wallenhorst T,Dewitte M,Siproudhis L,Bouguen G

    更新日期:2018-05-18 00:00:00

  • Mucosal healing in Crohn's disease: a systematic review.

    abstract::The traditional goals of Crohn's disease therapy, to induce and maintain clinical remission, have not clearly changed its natural history. In contrast, emerging evidence suggests that achieving and maintaining mucosal healing may alter the natural history of Crohn's disease, as it has been associated with more sustain...

    journal_title:Inflammatory bowel diseases

    pub_type: 杂志文章,评审


    authors: De Cruz P,Kamm MA,Prideaux L,Allen PB,Moore G

    更新日期:2013-02-01 00:00:00

  • Distinct Anti-IFI16 and Anti-GP2 Antibodies in Inflammatory Bowel Disease and Their Variation with Infliximab Therapy.

    abstract:BACKGROUND:Inflammatory bowel disease (IBD) is characterized by a chronic inflammation of the gut, partly driven by defects in the expression and function of pattern recognition receptors, including the IFI16 protein. Because this protein is a target for autoantibodies and its aberrant expression was reported in coloni...

    journal_title:Inflammatory bowel diseases

    pub_type: 杂志文章


    authors: Caneparo V,Pastorelli L,Pisani LF,Bruni B,Prodam F,Boldorini R,Roggenbuck D,Vecchi M,Landolfo S,Gariglio M,De Andrea M

    更新日期:2016-12-01 00:00:00

  • Comparison of QD and TID oral mesalazine for maintenance of remission in quiescent ulcerative colitis: a double-blind, double-dummy, randomized multicenter study.

    abstract:BACKGROUND:Mesalazine preparations are widely used to treat mild to moderately severe ulcerative colitis (UC). We compared once-daily administration of oral mesalazine in patients with quiescent UC with the established 3-times-daily prescription, assessing the efficacy and safety of each method in maintaining remission...

    journal_title:Inflammatory bowel diseases

    pub_type: 杂志文章,多中心研究,随机对照试验


    authors: Watanabe M,Hanai H,Nishino H,Yokoyama T,Terada T,Suzuki Y

    更新日期:2013-07-01 00:00:00

  • Intra- and interobserver variation in the use of the Vienna classification of Crohn's disease.

    abstract:BACKGROUND:Crohn's disease is a heterogeneous disease, and several classification systems have been developed to classify the patients in more homogeneous groups. Our aim was to assess the intra- and interobserver variation when classifying patients according to the widely used Vifenna classification. METHODS:Ten rand...

    journal_title:Inflammatory bowel diseases

    pub_type: 杂志文章


    authors: Riis L,Munkholm P,Binder V,Skovgaard LT,Langholz E

    更新日期:2005-07-01 00:00:00

  • Toll-like receptor 5 deficiency protects from wasting disease in a T cell transfer colitis model in T cell receptor-β-deficient mice.

    abstract:BACKGROUND:Toll-like receptor 5 (TLR5) is implicated in the innate and adaptive immune responses that are associated with inflammatory bowel disease (IBD). In humans TLR5 is expressed on CD4(+) T cells and costimulation with flagellin potentiates effector and regulatory T cell responses. The aim of this study was to de...

    journal_title:Inflammatory bowel diseases

    pub_type: 杂志文章


    authors: Hardenberg G,Yao Y,Piccirillo CA,Levings MK,Steiner TS

    更新日期:2012-01-01 00:00:00

  • Recommendations for Quality Colonoscopy Reporting for Patients with Inflammatory Bowel Disease: Results from a RAND Appropriateness Panel.

    abstract:BACKGROUND:Consensus on what constitutes a quality colonoscopy report for patients with inflammatory bowel disease (IBD) is lacking. We developed a template for quality colonoscopy reporting that can be used broadly by endoscopists. METHODS:After a literature review of topics relevant to colonoscopy reporting, members...

    journal_title:Inflammatory bowel diseases

    pub_type: 共识发展会议,杂志文章


    authors: Devlin SM,Melmed GY,Irving PM,Rubin DT,Kornbluth A,Kozuch PL,Raffals LE,Velayos FS,Sparrow MP,Baidoo L,Bressler B,Cheifetz AS,Jones J,Kaplan GG,Siegel CA

    更新日期:2016-06-01 00:00:00