Highlights
- •Non-invasive monitoring of IBD during pregnancy is challenging.
- •Women with IBD attending a multidisciplinary clinic were prospectively recruited.
- •A total of 265 fecal calprotectin (FC) measurements were obtained in 157 IBD pregnancy patients.
- •FC levels were directly correlated with disease activity throughout pregnancy.
- •Increased FC levels were found to predict disease relapse later in the course of gestation .
Abstract
Objectives
Inflammatory bowel diseases (IBDs) are commonly diagnosed in reproductive-aged women
and can substantially affect pregnancy outcomes. Non-invasive monitoring of IBD during
the prenatal course is particularly challenging as traditional laboratory biomarkers
are often affected by pregnancy-related physiologic changes. We aimed to evaluate
the role of fecal calprotectin (FC) in monitoring disease activity and predicting
relapse among IBD women throughout gestation.
Methods
Women with IBD attending a multidisciplinary clinic for the preconception, antenatal
and postnatal treatment were prospectively recruited during 2014–2018. FC levels were
determined with an enzyme-linked immunoassay.
Results
A total of 265 FC (preconception, n = 41; 1st trimester, n = 48; 2nd trimester, n = 84; 3rd trimester, n = 76; postpartum, n = 16) measurements were obtained in 157 pregnancies. Higher FC concentrations were
found in all time points in those with active disease than those in remission as assessed
by either physician global assessment or disease clinical scores. FC levels were significantly
correlated with physician global assessment and disease activity indices in all 5
periods of investigation. Excluding those with disease flare at the time of conception,
disease relapse was encountered during the prenatal course in 40 (31.5%) of the remaining
127 pregnancies. FC levels were significantly higher in those who experienced a disease
flare later in the course of gestation as compared to those who maintained clinical
remission (median 341 vs. 224 μg/g, P = 0.04).
Conclusion
FC appears to be a reliable marker of ongoing disease activity throughout the prenatal
course as well as a predictor of imminent disease flare among IBD pregnant patients.
Keywords
Abbreviations:
cd (crohn's disease), Crp (c reactive protein), Fc (fecal calprotectin), Ga (gestational age), IBD (inflammatory bowel diseases), PGA (physician global assessment), UC (ulcerative colitis)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: March 20, 2020
Accepted:
March 12,
2020
Received:
November 18,
2019
Identification
Copyright
© 2020 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
