A104 PREGNANCY OUTCOMES IN WOMEN WITH INFLAMMATORY BOWEL DISEASE AND EXPOSURE TO BIOLOGICS - A PROSPECTIVE COHORT STUDY
Bibliographic record
Abstract
Inflammatory bowel disease (IBD) has a peak incidence rate in women of reproductive age. Biologic agents are commonly used in IBD management. However, prospective safety data on biologics exposure in the pregnant population remain limited. To assess baseline differences, and to compare obstetrical and neonatal outcomes in women with IBD who are exposed and non-exposed to biologics during pregnancy. Since November 2014, pregnant women with ulcerative colitis (UC) or Crohn’s disease (CD) were enrolled in a prospective registry. Patients were assessed every trimester, and at three, six, and 12-months post-partum. Disease activity, pregnancy complications, and delivery and newborn outcomes were recorded. Women were divided into exposed (adalimumab [ADA], infliximab [IFX], vedolizumab [VDZ], or ustekinumab [UST]) and non-exposed (no medications or 5-aminosalicylic acid [5-ASA]) groups. Patients taking only immunomodulators were excluded. Mann–Whitney U and Fisher’s exact tests were used to identify differences between groups. To date, 36 patients have been enrolled in the study, totalling 38 pregnancy events. Sixteen pregnancy events were exposed to biologics: 9 (56.2%) ADA, 4 (25.0%) IFX, 2 (12.5%) VDZ, 1 (6.2%) UST. Twenty-two pregnancy events were not exposed: 8 (36.4%) 5-ASAs and 14 (64.6%) no medications. Within the exposed and non-exposed groups, 13 (81.3%) and 14 (63.6%) women had CD, respectively. The exposed group had fewer patients with a smoking history (1 [6.3%] vs 11 [50.0%], p=0.04), while a higher proportion had an annual household income above $100,000 (11 [78.6%] vs 7 [35.0%], p=0.012). No differences were observed between groups for adverse pregnancy diagnoses (gestational hypertension and diabetes, preeclampsia/eclampsia), post-partum infections, and neonatal outcomes (low birth weight, prematurity, and infections). Disease relapse during pregnancy (5 [31.3%] vs 8 [36.4%], p=0.74) and steroid use (4 [25%] vs 3 [13.6%], p=0.42) were similar between exposed and non-exposed groups, respectively. Caesarian section (CS) occurred in 7 (46.7%) of exposed and 10 (62.5%) of non-exposed group (p=0.38), while 6 (16.7%) patients in total had active perianal disease. There was a trend towards significance for increased emergency CS within the non-exposed (6 [37.5%]) compared to exposed group (1 [6.7%], p=0.08). No significant difference was observed for breast feeding rates between groups. Biologics exposure does not appear to be associated with adverse pregnancy and neonatal outcomes. Higher socioeconomic status was linked to women using biologics during pregnancy. A high CS rate was also observed overall while few had an IBD-related indication. Future studies should explore any barriers to accessing biologics in Canada, and the propensity for CS in women with IBD. Saskatchewan Health Research Foundation (SHRF)
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".