Poster Session 1
Category: Medical/Surgical/Diseases/Complications
Poster Session 1
Weirui Xiao, MD (she/her/hers)
David Geffen School of Medicine at University of California, Los Angeles (UCLA)
Los Angeles, California, United States
Johanna Bedoy, BS
David Geffen School of Medicine at University of California, Los Angeles (UCLA)
Los Angeles, California, United States
Mehrnaz Siavoshi, MPH, MS
Department of Urology, David Geffen School of Medicine at University of California, Los Angeles (UCLA)
Los Angeles, California, United States
Lorna Kwan, BS, MPH
Principal Statistician
Department of Urology, David Geffen School of Medicine at University of California, Los Angeles (UCLA)
Los Angeles, California, United States
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Thalia Mok, MD
Assistant Professor
David Geffen School of Medicine at University of California, Los Angeles (UCLA)
Los Angeles, California, United States
Nirupama Bonthala, MD
David Geffen School of Medicine at University of California, Los Angeles (UCLA)
Los Angeles, California, United States
Ilina Pluym, MD
David Geffen School of Medicine at University of California, Los Angeles (UCLA)
Los Angeles, California, United States
To investigate predictors of hypertensive disorders of pregnancy (HDP) in patients with inflammatory bowel disease (IBD) and evaluate the use of low-dose aspirin (LDA) prophylaxis.
Study Design:
This was a retrospective cohort study of all singleton pregnancies with a history of IBD who delivered at a single academic center from January 2019 to December 2023. Primary outcome was development of HDP, including gestational hypertension or preeclampsia. Baseline characteristics, LDA use, pregnancy outcomes, and IBD disease activity measured by remission status or flares during the pregnancy were collected. The Kruskal-Wallis test or Chi-squared test of independence was performed. Multivariate logistic regression was used to identify independent predictors of HDP.
Results:
Of 100 deliveries among 89 patients with IBD, 22 (22%) were complicated by HDP. Baseline characteristics, including maternal age (36.3 years vs 33.9 years, p=0.06 and obesity (31.8% vs 21.8%, p=0.33), were not significantly different between groups. HDP was more likely to occur among patients who had a history of HDP (22.7% vs 2.6%, p< 0.01) or concurrent gestational diabetes (3.8% vs 18.2%, p = 0.02) (Table 1). Fetal fraction on cell-free fetal DNA (cfDNA) was lower in pregnancies with HDP (8.0% vs 10.3%, p=0.01). HDP did not differ by clinical remission rates (86.4% vs 85.9%, p=0.86) or IBD flares during pregnancy (22.7% vs 15.4%, p=0.42). In multivariate analysis, prior HDP remained a significant predictor (aOR 6.98, 95% CI 1.24-39.8; Table 2). LDA for preeclampsia prevention was reported in 16% (n=16) and was similar in patients who did and did not develop HDP (22.7% vs 14.1%, p=0.33)
Conclusion:
HDP occurred in over one in five pregnancies among patients with IBD and did not appear to be related to disease activity. Despite elevated risk, LDA prophylaxis appeared underutilized in this cohort. Further studies are needed to determine the risk-benefit ratio of LDA use in pregnancies with IBD.