Ulcerative colitis and pregnancy: An increased risk of negative outcomes?

Ulcerative colitis (UC) commonly affects women in early adulthood when child hearing is a frequent event. Patients are often worried about the effects of the disease and its medical treatment on the outcome of a pregnancy and about the effect of pregnancy on the disease itself. Twenty eight pregnant UC patients (for a total of 34 pregnancies), were followed at the Gastroenterology Department in Florence in the period 1982 to 1992. Four additional pregnancies were voluntarily interrupted. The diagnosis of UC had been previously made on the basis of clinical, endoscopic and radiological criteria and was confirmed histologically. All patients were initially in remission: 9 pregnancies were started without therapy, while in the other 25 a medical treatment was given routinely (5-aminosalicylic acid at a mean dose of 1.5 g/day). Among 10 patients who relapsed, only two needed a steroid therapy. The incidence of spontaneous abortions (4) and stillbirths (1), appears to be increased in this small series in comparison with the frequency found in the general population. The occurrence of negative outcomes was higher in relapsed and multiparous patients. The authors discuss these findings.