Het natuurlijk beloop van inflammatoire darmziekten tijdens de zwangerschap

Crohn’s disease and ulcerative colitis, collectively referred to as inflammatory bowel disease (IBD), are chronic, relapsing diseases. The exact etiology remains unknown, however, it is currently believed to be a complex interaction between genetic susceptibility, gut microbiota, the host immune response and environmental factors(1). IBD typically arises at a young, fertile age, as 50% of patients will be younger than 35 years old when the diagnosis is established(2). Therefore, reproductive issues are of important concern for both the IBD patients and their treating physicians. Preconception counseling in these patients remains challenging, as many complex questions can only be answered with limited, mainly retrospective and sometimes conflicting data. In addition, most of the (registry based) cohorts are outdated(3-10), not including the most recent therapies for IBD like anti-TNF, which have become a mainstay in IBD treatment over the last decade(11). Obviously, the need for an up-to-date, properly conducted, prospective cohort is long overdue. We therefore propose to conduct a prospective cohort study in IBD females with a pregnancy wish and pregnant IBD females, to gather data on IBD characteristics during pregnancy and the effect of pregnancy on IBD. Furthermore, as a recent study has shown pregnancy to influence gut microbiota in non IBD patients(12), we also propose to investigate whether the gut microbiome in IBD patients changes during pregnancy and whether these changes have any clinical implications.

The gut microbiome changes profoundly during pregnancy in healthy women. We hypothesize these microbiome changes will also occur in pregnant IBD women and can possibly have clinical implications.

Visit 1: before pregnancy (when patient expresses a pregnancy wish)

Visit 2: First trimester (gestational week 10)

Visit 3: Second trimester (gestational week 20)

Visit 4: Third trimester (gestational week 30)

1 year after delivery: retrospectively obtain health data on th child via General Practitioner

No interventions

4 visits (1 before pregnancy, and 1 in each trimester) to obtain blood samples, fecal samples and questionnaires