Pregnancy, delivery, and neonatal outcomes among women with irritable bowel syndrome (IBS) an evaluation of over 9 million deliveries

Objective Evaluate the associations between irritable bowel syndrome (IBS) and pregnancy, delivery, and neonatal outcomes, using a population database cohort. Methods We conducted a retrospective analysis utilizing the Health Care Cost and Utilization Project-Nationwide Inpatient Sample database over 11 years from 2004 to 2014. A delivery cohort was created using ICD-9 codes. ICD-9 code 564.1 was used to extract the cases of IBS. Pregnant women with IBS (study group) were compared to pregnant women without IBS (control). A multivariate logistic regression model was used to adjust for statistically significant variables (p value <.05). Results There were a total of 9,096,788 deliveries during the study period. Of those, 8962 pregnant women were found to have IBS. The prevalence of IBS increased from 47.96 to 172.68 per 100,000 women during the study period. Compared to the control group, women with IBS were more likely to be Caucasian, older, have higher incomes and private insurance plans (p < .0001, in all cases). In addition, they were more likely to be obese, smokers, hypertensive, IVF pregnancies, have multiple gestations, thyroid disorders, chronic interstitial cystitis, fibromyalgia and have psychiatric disorders (p < .0001 in all cases). Women with IBS were more likely to experience pregnancy-induced hypertension (aOR 1.11, 95% CI 1.02-1.21), preeclampsia (aOR 1.23, 95% CI 1.09-1.38), deep venous thrombosis (aOR 2.26, 95% CI 1.12-4.57), and gestational diabetes (aOR 1.1, 95% CI 1.002-1.22) compared to the non-IBS group. Congenital anomalies were encountered in 1.7% of the IBS group compared to 0.4% in the control group (aOR 2.57, 95% CI 2.13-3.09). Conclusion When controlling for confounding effects, IBS is associated with an increased risk for preeclampsia, DVT and increased risk for congenital malformation.