Impact of the coronavirus infectious disease (COVID-19) pandemic on the provision of inflammatory bowel disease (IBD) antenatal care and outcomes of pregnancies in women with IBD

Background The impact of COVID-19 on pregnant inflammatory bowel disease (IBD) patients is currently unknown. Reconfiguration of services during the pandemic may negatively affect medical and obstetric care. We aimed to examine the impacts on IBD antenatal care and pregnancy outcomes.Methods Retrosp...

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Main Authors: Shaji Sebastian, Rachel Cooney, Jimmy Limdi, Helen Steed, Aaron Bancil, Veronica Hall, Paul Collins, Christian Philipp Selinger, Alexandra Kent, Aileen Fraser, Lyn Smith, Melanie Gunn, Thean Soon Chew, Georgina Kerry, Kamal V Patel, Maya Roysam, Klaartje Bel Kok
Format: Article
Language:English
Published: BMJ Publishing Group 2021-10-01
Series:BMJ Open Gastroenterology
Online Access:https://bmjopengastro.bmj.com/content/8/1/e000603.full
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author Shaji Sebastian
Rachel Cooney
Jimmy Limdi
Helen Steed
Aaron Bancil
Veronica Hall
Paul Collins
Christian Philipp Selinger
Alexandra Kent
Aileen Fraser
Lyn Smith
Melanie Gunn
Thean Soon Chew
Georgina Kerry
Kamal V Patel
Maya Roysam
Klaartje Bel Kok
author_facet Shaji Sebastian
Rachel Cooney
Jimmy Limdi
Helen Steed
Aaron Bancil
Veronica Hall
Paul Collins
Christian Philipp Selinger
Alexandra Kent
Aileen Fraser
Lyn Smith
Melanie Gunn
Thean Soon Chew
Georgina Kerry
Kamal V Patel
Maya Roysam
Klaartje Bel Kok
author_sort Shaji Sebastian
collection DOAJ
description Background The impact of COVID-19 on pregnant inflammatory bowel disease (IBD) patients is currently unknown. Reconfiguration of services during the pandemic may negatively affect medical and obstetric care. We aimed to examine the impacts on IBD antenatal care and pregnancy outcomes.Methods Retrospective data were recorded in consecutive patients attending for IBD antenatal care including outpatient appointments, infusion unit visits and advice line encounters.Results We included 244 pregnant women with IBD, of which 75 (30.7%) were on biologics in whom the treatment was stopped in 29.3% at a median 28 weeks gestation. In addition, 9% of patients were on corticosteroids and 21.5% continued on thiopurines. The care provided during 460 patient encounters was not affected by the pandemic in 94.1% but 68.2% were performed via telephone (compared with 3% prepandemic practice; p<0.0001). One-hundred-ten women delivered 111 alive babies (mean 38.2 weeks gestation, mean birth weight 3324 g) with 12 (11.0%) giving birth before week 37. Birth occurred by vaginal delivery in 72 (56.4%) and by caesarean section in 48 (43.6%) cases. Thirty-three were elective (12 for IBD indications) and 15 emergency caesarean sections. Breast feeding rates were low (38.6%). Among 244 pregnant women with IBD, 1 suspected COVID-19 infection was recorded.Conclusion IBD antenatal care adjustments during the COVID-19 pandemic have not negatively affected patient care. Despite high levels of immunosuppression, only a single COVID-19 infection occurred. Adverse pregnancy outcomes were infrequent.
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spelling doaj-art-5487b3a5ea4e4006b88c039845bd6c442025-08-20T02:20:37ZengBMJ Publishing GroupBMJ Open Gastroenterology2054-47742021-10-018110.1136/bmjgast-2021-000603Impact of the coronavirus infectious disease (COVID-19) pandemic on the provision of inflammatory bowel disease (IBD) antenatal care and outcomes of pregnancies in women with IBDShaji Sebastian0Rachel Cooney1Jimmy Limdi2Helen Steed3Aaron Bancil4Veronica Hall5Paul Collins6Christian Philipp Selinger7Alexandra Kent8Aileen Fraser9Lyn Smith10Melanie Gunn11Thean Soon Chew12Georgina Kerry13Kamal V Patel14Maya Roysam15Klaartje Bel Kok165Gastroenterology and Hepatology, Hull and East Yorkshire Hospitals NHS Trust, Hull11 Gastroenterology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK10 Section of IBD, Division of Gastroenterology, Pennine Acute Hospitals NHS Trust, Manchester, UKGastroenterology, University of Wolverhampton, Wolverhampton, UK5Department of Gastroenterology, Royal London Hospital, Barts Health NHS Trust, London, UKGastroenterology, Royal Bolton Foundation NHS Trust, Bolton, UK10 Department of Gastroenterology, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UKLeeds Gastroenterology Institute, Leeds Teaching Hospitals NHS Trust, Leeds, UKGastroenterology, King`s College Hospital NHS Foundation Trust, London, UK2University Hospitals of Bristol, Bristol, UKGastroenterology, NHS Greater Glasgow and Clyde North Glasgow University Hospitals Division, Glasgow, UKGastroenterology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, Tyne and Wear, UKAcademic Unit of Gastroenterology, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UKDepartment of Gastroenterology, St Georges Hospital, London, UK5 Department of Gastroenterology, St George`s University Hospitals NHS Foundation Trust, London, UKLeeds Gastroenterology Institute, Leeds Teaching Hospitals NHS Trust, Leeds, UK4 Department of Gastroenterology, Barts Health NHS Trust, London, UKBackground The impact of COVID-19 on pregnant inflammatory bowel disease (IBD) patients is currently unknown. Reconfiguration of services during the pandemic may negatively affect medical and obstetric care. We aimed to examine the impacts on IBD antenatal care and pregnancy outcomes.Methods Retrospective data were recorded in consecutive patients attending for IBD antenatal care including outpatient appointments, infusion unit visits and advice line encounters.Results We included 244 pregnant women with IBD, of which 75 (30.7%) were on biologics in whom the treatment was stopped in 29.3% at a median 28 weeks gestation. In addition, 9% of patients were on corticosteroids and 21.5% continued on thiopurines. The care provided during 460 patient encounters was not affected by the pandemic in 94.1% but 68.2% were performed via telephone (compared with 3% prepandemic practice; p<0.0001). One-hundred-ten women delivered 111 alive babies (mean 38.2 weeks gestation, mean birth weight 3324 g) with 12 (11.0%) giving birth before week 37. Birth occurred by vaginal delivery in 72 (56.4%) and by caesarean section in 48 (43.6%) cases. Thirty-three were elective (12 for IBD indications) and 15 emergency caesarean sections. Breast feeding rates were low (38.6%). Among 244 pregnant women with IBD, 1 suspected COVID-19 infection was recorded.Conclusion IBD antenatal care adjustments during the COVID-19 pandemic have not negatively affected patient care. Despite high levels of immunosuppression, only a single COVID-19 infection occurred. Adverse pregnancy outcomes were infrequent.https://bmjopengastro.bmj.com/content/8/1/e000603.full
spellingShingle Shaji Sebastian
Rachel Cooney
Jimmy Limdi
Helen Steed
Aaron Bancil
Veronica Hall
Paul Collins
Christian Philipp Selinger
Alexandra Kent
Aileen Fraser
Lyn Smith
Melanie Gunn
Thean Soon Chew
Georgina Kerry
Kamal V Patel
Maya Roysam
Klaartje Bel Kok
Impact of the coronavirus infectious disease (COVID-19) pandemic on the provision of inflammatory bowel disease (IBD) antenatal care and outcomes of pregnancies in women with IBD
BMJ Open Gastroenterology
title Impact of the coronavirus infectious disease (COVID-19) pandemic on the provision of inflammatory bowel disease (IBD) antenatal care and outcomes of pregnancies in women with IBD
title_full Impact of the coronavirus infectious disease (COVID-19) pandemic on the provision of inflammatory bowel disease (IBD) antenatal care and outcomes of pregnancies in women with IBD
title_fullStr Impact of the coronavirus infectious disease (COVID-19) pandemic on the provision of inflammatory bowel disease (IBD) antenatal care and outcomes of pregnancies in women with IBD
title_full_unstemmed Impact of the coronavirus infectious disease (COVID-19) pandemic on the provision of inflammatory bowel disease (IBD) antenatal care and outcomes of pregnancies in women with IBD
title_short Impact of the coronavirus infectious disease (COVID-19) pandemic on the provision of inflammatory bowel disease (IBD) antenatal care and outcomes of pregnancies in women with IBD
title_sort impact of the coronavirus infectious disease covid 19 pandemic on the provision of inflammatory bowel disease ibd antenatal care and outcomes of pregnancies in women with ibd
url https://bmjopengastro.bmj.com/content/8/1/e000603.full
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