Influence of pregnancy on outcomes of inflammatory bowel disease and treatment discontinuation

doi:10.3748/wjg.120573

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Observational Study

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastroenterol. Nov 21, 2026; 32(43): 120573
Published online Nov 21, 2026. doi: 10.3748/wjg.120573

Table 1 Demographics, clinical characteristics, and laboratory data of the entire study group and subgroups according to inflammatory bowel disease type, median (interquartile range)/n (%)

	Study group (n = 57)	UC (n = 37)	CD (n = 20)
Age at onset of disease, years	22 (18-25.5)	23 (19.5-26)	20.5 (17.25-24.75)
Total disease duration, months	109 (72-154.23)	98.87 (65.37-151.88)	119.22 (94.53-197.03)
Smoking
None	50 (87.7)	34 (91.9)	16 (80)
Existing/current	7 (12.3)	3 (8.1)	4 (20)
BMI (kg/m²)	20.82 (18.59-23.44)	21.14 (17.44-24.1)	20.81 (19.4-22.77)
Family history of IBD	6 (10.5)	3 (8.1)	3 (15)
Appendectomy	4 (7)	1 (2.7)	3 (15)
UC disease extension
Proctitis		3 (8.1)
Left-sided		19 (51.4)
Extensive		15 (40.5)
CD disease location
Ileal (L1)			8 (40)
Colonic (L2)			4 (20)
Ileo-colonic (L3)			8 (40)
CD perianal involvement			8 (40)
CD disease behavior
Inflammatory disease (B1)			12 (60)
Stenosing (B2)			4 (20)
Penetrating (B3)			4 (20)
Extraintestinal manifestations	27 (47.4)	16 (43.2)	11 (55)
Erythema nodosum	1 (1.8)		1 (5)
Pyoderma gangrenous	1 (1.8)	1 (2.7)
Peripheral arthralgia	17 (29.8)	10 (27)	7 (35)
Peripheral arthritis	9 (15.8)	6 (16.2)	3 (15)
Back pain	11 (19.3)	5 (13.5)	6 (30)
Ankylosing spondylitis	4 (7)	1 (2.7)	3 (15)
Sacroiliitis	2 (3.5)	1 (2.7)	1 (5)
Aphthous ulcer	8 (14)	5 (13.5)	3 (15)
Current treatment	42 (73.7)	26 (70.3)	16 (80)
Mesalazine	24 (42.1)	21 (56.8)	3 (15)
Thiopurine	3 (5.3)	2 (5.4)	1 (5)
Biologics
Adalimumab	5 (8.8)	1 (2.7)	4 (20)
Infliximab	8 (14)	1 (2.7)	7 (35)
Vedolizumab	2 (3.5)	1 (2.7)	1 (2.7)
Prior major abdominal surgery
Resection	8 (14)		8 (40)
Total colectomy	2 (3.5)	2 (5.4)
CRP (mg/L)	8 (5-19.7)	6.14 (5-10.75)	17.1 (5.25-60)
HB (g/dL)	11.4 (10.03-12)	11.7 (10.1-12)	10.65 (9.68-12.6)
Albumin (g/dL)	4 (4-4.4)	4 (4-4.3)	4.15 (3.85-4.48)
Baseline partial Mayo score		6 (4-7.5)
Baseline Mayo endoscopic score		2 (2-3)
Baseline CDAI			330.5 (244.75-438.25)

BMI: Body mass index; IBD: Inflammatory bowel disease; UC: Ulcerative colitis; CD: Crohn’s disease; CRP: C-reactive protein; HB: Hemoglobin; CDAI: Crohn’s disease activity index.

Full Size Table

Table 2 Clinical outcomes and demographic data of patients with ulcerative colitis who continued and discontinued therapy, median (interquartile range)/n (%)

Characteristic	Continued treatment (n = 25)	Discontinued treatment (n = 12)	P value
Age at onset of disease, years	23 (11-32)	21.5 (14-25)	0.235
Total disease duration, months	109 (39.33-208.23)	75.07 (28.4-347.47)	0.364
Smoking			1
None	23 (92)	11 (91.7)
Existing/current	2 (8)	1 (8.3)
BMI (kg/m²)	21.45 (16.69-26.4)	20.44 (14.69-24.98)	0.549
Family history of IBD	2 (8)	1 (8.3)	1
Appendectomy		1 (8.3)	0.324
UC disease extension			0.699
Proctitis	2 (8)	1 (8.3)
Left-sided	14 (56)	5 (41.7)
Extensive	9 (36)	6 (50)
CRP (mg/L)	5 (1-30)	8.15 (0.75-20)	0.562
HB (g/dL)	12 (6.2-14.6)	10.1 (8.4-13)	0.037^a
Albumin (g/dL)	4 (3.5-5.1)	4 (3.5-4.4)	0.033^a
Mayo partial score	5 (1-9)	7 (4-8)	0.018^a
Mayo endoscopic score	2 (0-3)	2.5 (2-3)	0.009^a
Disease activation	6 (24)	9 (75)	0.005^a
Current treatment	19 (76)	7 (58.3)	0.271
Mesalazine	14 (56)	7 (58.3)	0.893
Thiopurine	2 (8)		1
Biologics
Adalimumab	1 (4)		1
Infliximab	1 (4)		1
Vedolizumab	1 (4)		1
History of abortion	9 (36)	4 (33.3)	1
IUGR	2 (8)	1 (4)
Low birth weight	3 (12)	2 (8)

^aP < 0.05.

BMI: Body mass index; IBD: Inflammatory bowel disease; UC: Ulcerative colitis; CRP: C-reactive protein; HB: Hemoglobin; IUGR: Intrauterine growth retardation.

Full Size Table

Table 3 Clinical outcomes and demographic data of patients with Crohn’s disease who continued and discontinued therapy, median (interquartile range)/n (%)

	Continued treatment (n = 16)	Discontinued treatment (n = 4)	P value
Age at onset of disease, years	19 (11-27)	22 (18-24)	0.704
Total disease duration, months	112.2 (20.27-328.73)	154.83 (74.33-261.17)	0.508
Smoking			0.162
None	14 (87.5)	2 (50)
Existing/current	2 (12.5)	2 (50)
BMI (kg/m²)	20.2 (16.02-26.73)	21.72 (20.81-23.44)	0.300
Family history of IBD	2 (12.5)	1 (25)	0.509
Appendectomy	2 (12.5)	1 (25)	0.509
CD disease location			0.535
Ileal (L1)	6 (37.5)	2 (50)
Colonic (L2)	4 (25)
Ileo-colonic (L3)	6 (37.5)	2 (50)
CD perianal involvement	6 (37.5)	2 (50)	1
CD disease behavior			0.189
Inflammatory disease (B1)	10 (62.5)	2 (50)
Stenosing (B2)	2 (12.5)	2 (50)
Penetrating (B3)	4 (25)
CRP (mg/L)	15.4 (0.8-166)	17.7 (0.5-60)	0.741
HB (g/dL)	10.45 (8.4-15)	12.8 (10.5-14.4)	0.065
Albumin (g/dL)	4.05 (2.9-4.9)	4.4 (3.8-4.6)	0.419
CDAI	334.5 (216-514)	302 (202-456)	0.705
Disease activation	9 (56.3)	1 (25)	0.582
Current treatment	12 (75)	4 (100)	0.538
Mesalazine		3 (75)	0.004^a
Thiopurine	1 (6.3)		1
Biologics
Adalimumab	4 (25)		0.538
Infliximab	6 (37.5)	1 (25)	1
Vedolizumab	1 (6.3)		1
History of abortion	5 (31.3)	1 (25)	1

^aP < 0.01.

BMI: Body mass index; IBD: Inflammatory bowel disease; CD: Crohn’s disease; CRP: C-reactive protein; HB: Hemoglobin; CDAI: Crohn’s Disease Activity Index.

Full Size Table

Table 4 Demographics, clinical characteristics, and laboratory data of the whole study group and subgroups according to treatment discontinuation, median (interquartile range)/n (%)

	CD-study group (n = 20)	No-activation (n = 10)	Activation (n = 10)	P value	UC-study group (n = 37)	No-activation (n = 22)	Activation (n = 15)	P value
Age at onset of disease, years	20.5 (17.25-24.75)	19.5 (18-24)	21.5 (14.25-26)	0.970	23 (19.5-26)	23 (19.75-26.25)	22 (19-25)	0.675
CRP (mg/L)	17.1 (5.25-60)	17.1 (6.8-22.5)	34.5 (4-101.75)	0.597	6.14 (5-10.75)	5 (5-11.5)	7.4 (5-10)	0.883
HB (g/dL)	10.65 (9.68-12.6)	10.85 (10.28-12.7)	10.55 (9.18-13.05)	0.677	11.7 (10.1-12)	11.8 (10.2-12)	11.7 (10-12)	0.948
Albumin (g/dL)	4.15 (3.85-4.48)	4.3 (4.03-4.43)	4 (3.28-4.6)	0.287	4 (4-4.3)	4 (4-4.3)	4 (4-4.4)	0.797
Cause of treatment discontinuation				0.582				0.012^a
None	16 (80)	7 (70)	9 (90)		25 (67.6)	19 (86.4)	6 (40)
Patient choice	4 (20)	3 (30)	1 (10)		9 (24.3)	2 (9.1)	7 (46.7)
Physician advisement					3 (8.1)	1 (4.5)	2 (13.3)
Salvage therapy				0.303				< 0.001^b
Steroid needed	5 (25)		4 (40)		8 (21.6)		8 (53.3)
Cause of activation
None	10 (50)	10 (100)			22 (59.5)	22 (100)
Pregnancy	9 (45)		9 (90)		10 (27)		10 (66.7)
Treatment discontinuation	1 (5)		1 (10)		3 (8.1)		3 (20)
Both					2 (5.4)		2 (13.3)
Mode of delivery				1				0.405
Live birth	18 (90)	9 (90)	9 (90)		36 (97.3)	22 (100)	14 (93.3)
NA	6 (30)	4 (40)	2 (20)		8 (21.6)	1 (4.5)	7 (46.7)
Normal delivery	4 (20)	1 (10)	3 (30)		14 (37.8)	12 (54.5)	2 (13.3)
Cesarean section	8 (40)	4 (40)	4 (40)		14 (37.8)	9 (40.9)	5 (33.3)
Abortion	2 (10)	1 (10)	1 (10)		1 (2.7)		1 (6.7)

^aP < 0.05.

^bP < 0.001.

CRP: C-reactive protein; HB: Hemoglobin; NA: Not available; CD: Crohn’s disease; UC: Ulcerative colitis.

Full Size Table

Citation: Ozturk O, Durak MB, Cagir Y, Ergul M, Keskin ET, Yilmaz E, Acun KC, Atay A, Yuksel I. Influence of pregnancy on outcomes of inflammatory bowel disease and treatment discontinuation. World J Gastroenterol 2026; 32(43): 120573
URL: https://www.wjgnet.com/1007-9327/full/v32/i43/120573.htm
DOI: https://dx.doi.org/10.3748/wjg.120573

Ozturk O, Durak MB, Cagir Y, Ergul M, Keskin ET, Yilmaz E, Acun KC, Atay A, Yuksel I. Influence of pregnancy on outcomes of inflammatory bowel disease and treatment discontinuation. World J Gastroenterol 2026; 32(43): 120573 [DOI: 10.3748/wjg.120573]

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