Pregnancy outcomes in women with inflammatory bowel disease requiring hospitalisation: a retrospective cohort study

Introduction Pregnancy in women with inflammatory bowel disease (IBD) is associated with increased risk of complications, particularly when disease activity is uncontrolled. Antenatal hospital admissions may reflect underlying disease activity or pregnancy-related complications and may adversely affect pregnancy outcomes. We aimed to examine the causes of antenatal hospital admissions and obstetric and fetal outcomes. Methods We included completed pregnancies in women with a confirmed diagnosis of Crohn’s disease (CD), ulcerative colitis (UC) or IBD-unclassified (IBD-U), followed between May 2014 and March 2025 who had at least one hospital admission during pregnancy. Data were collected retrospectively on IBD history, disease activity assessed according to the Global Physician Assessment, treatment, reasons for admission, investigations and pregnancy outcomes. Results A total of 56 pregnancies in women with IBD were included. The mean maternal age was 31 years; 27 had CD, 26 UC and 3 IBD-U. 36 of all hospitalisations were IBD-related. The main reason for the admission was disease flares. Other IBD-related causes included stoma complications, abdominal pain, perianal issues, gastrointestinal bleeding and one intestinal perforation. Non-IBD admissions were mainly for obstetric complications or infections. Conclusion Pregnant women with IBD remain at risk of both disease-related and obstetric complications requiring hospitalisation, underscoring the need for tailored multidisciplinary care and proactive monitoring throughout pregnancy.