Low Incidence of Venous Thromboembolism and Pre-Eclampsia in Women Cared for in a Specialist Antenatal Clinic for Inflammatory Bowel Disease

<b>Background/Objectives</b>: Pregnant women with Inflammatory Bowel Disease (IBD) require careful management to ensure optimal maternal and fetal outcomes. Whether IBD is a risk factor for pre-eclampsia is controversial. We aimed to investigate the incidence of venous thromboembolism (VTE), pre-eclampsia, and risk of disease flare from low-dose aspirin. <b>Methods:</b> This is a retrospective study of the Leeds combined IBD antenatal clinic providing joint specialist gastroenterology and obstetric consultations from 2015 to 2024. Primary outcomes were incidence of VTE, incidence of pre-eclampsia, and disease flare whilst taking aspirin. <b>Results:</b> In 574 pregnancies a single episode of VTE occurred. Adherence to VTE prophylaxis guidelines was good for post-partum periods but only 2 of 51 cases with third-trimester flare received the required VTE prophylaxis. The incidence of pre-eclampsia in this cohort was low at 2.7%. The majority of women deemed high-risk for pre-eclampsia received prophylaxis with aspirin in accordance with guidelines. The risk of symptomatic disease flare was not increased for aspirin users (21.6% versus 22.2% for non-users (<i>p</i> = 0.61)). <b>Conclusions:</b> The incidence of VTE and pre-eclampsia was low in this cohort of pregnant women with IBD. Pre-eclampsia prophylaxis in adherence to guidelines was good and was not associated with an increased flare risk. VTE prophylaxis for third-trimester flares was insufficient and requires better attention from IBD specialists, who are most likely to encounter patients with IBD flares.