Abstract Background Pregnancy in women with inflammatory bowel disease (IBD) may be associated with an increased risk of maternal and neonatal complications. However, data regarding pregnancy outcomes in patients who have undergone IBD-related surgery prior to conception remain limited. This study aimed to assess the impact of preconception IBD-related surgery on maternal and neonatal outcomes. Methods Retrospective cohort study including pregnancies followed at the Leeds combined IBD–pregnancy clinic between May 2014 and November 2024. Demographic characteristics, disease phenotype, and pregnancy outcomes were recorded. Eligible participants were women with a confirmed IBD diagnosis and a completed pregnancy. Categorical variables were compared using Chi-square or Fisher’s exact tests, and associations were expressed as odds ratios (95% CI); p 0.05 was considered statistically significant. Results A total of 550 pregnancies were included; 111 (20.2%) occurred in patients with prior IBD-related surgery. Crohn’s disease (CD) was significantly more frequent among those with surgery compared with the rest of the cohort (76.6% vs 37.1%, p 0.001; OR = 5.46, 95% CI 3.27–9.14). Biologic exposure during pregnancy (28.8% vs 26.0%, p = 0.59; OR = 1.15, 95% CI 0.72–1.84) and steroid use (9.9% vs 13.2%, p = 0.38; OR = 0.72, 95% CI 0.36–1.44) were comparable between groups. Moderate or severe disease activity during pregnancy was observed not more commonly observed in women with prior surgery (7.2% vs 11.4%; p = 0.20; OR = 0.61, 95% CI 0.28–1.32).Hospital admission during pregnancy was more common in the surgery group (18.0% vs 8.4%, p = 0.004; OR = 2.41, 95% CI 1.31–4.44). Preterm delivery occurred in 12.1% vs 6.7% (p = 0.08; OR = 1.92, 95% CI 0.94–3.90), and low birth weight (2500 g) in 9.0% vs 6.8% (p = 0.45; OR = 1.35, 95% CI 0.63–2.90) of women with and without prior surgery respectively. Caesarean section was significantly more frequent in women with prior surgery (46.8% vs 31.4%, p = 0.004; OR = 1.96, 95% CI 1.23–3.11). Rates of pre-eclampsia (2.7% vs 6.2%, p = 0.22; OR = 0.42, 95% CI 0.12–1.45), gestational diabetes (9.0% vs 6.2%, p = 0.35; OR = 1.50, 95% CI 0.69–3.25), and stillbirth/miscarriage (3.6% vs 1.8%, p = 0.26; OR = 2.01, 95% CI 0.60–6.75) did not differ significantly between groups. Conclusion Women with prior IBD-related surgery were more likely to have CD, hospitalisation during pregnancy, and caesarean delivery. No other significant differences in maternal or neonatal outcomes were observed between groups. While prior surgery is associated with a higher risk of hospitalisation and a higher rate of caesarean section maternal and fetal outcomes are equally good in women with prior surgery. Conflict of interest: Rellou, Sofia: No conflict of interest Gosling, Amy: No conflict of interest Rosiou, Konstantina: No COI Glanville, Tracey: No conflict of interest Selinger, Christian Philipp: CPS has received unrestricted research grants from Warner Chilcott, Janssen, Galapagos and AbbVie, has provided consultancy to Warner Chilcott, Dr Falk, AbbVie, Takeda, Fresenius Kabi, Eli Lilly, Galapagos, Ferring, Arena and Janssen, and had speaker arrangements with Warner Chilcott, Dr Falk, Galapagos, AbbVie, MSD, Pfizer, Eli Lilly, BMS, UCB, Fresenius Kabi, Celltrion and Takeda.
Rellou et al. (Thu,) studied this question.