P0520 - IBS is Prevalent Amongst Pregnant Women

Sunday, October 22, 2023

3:30 PM – 7:00 PM PT

Location: Exhibit Hall

Presenting Author(s)

Yuying Luo, MD

Center of GI Physiology and Motility at Mount Sinai West
New York, NY

Christie Lee Luo, MPH¹, Yuying Luo, MD², Rachel Meislin, MD¹, Eunyoung Yang, MS¹, Xiaotao Zhang, MD, PhD¹
¹Icahn School of Medicine at Mount Sinai, New York, NY; ²Center of GI Physiology and Motility at Mount Sinai West, New York, NY

Introduction: Irritable bowel syndrome (IBS) is prevalent globally with a female predominance at about 10% of the adult population using Rome IV criteria. Differences in sex hormones can modulate motility, visceral pain perception and intestinal permeability. Many physiologic changes occur during pregnancy and post-partum and the prevalence of IBS in pregnant patients has not been rigorously assessed.

Methods: We constructed a cohort of all delivery hospitalizations for individuals 15-49 years of age that occurred between 2013-2019 using a national healthcare claims database (IBM MarketScan). ICD-9 and ICD-10 codes were used to develop a cohort of patients with at least one pregnancy. Diagnoses with similar presentations to IBS (e.g. celiac, gastrointestinal cancers and inflammatory bowel disease) were excluded. Obstetric, psychological, and other medical comorbidities were also examined.

Results: In this study, we examined 77,517 pregnancies with a mean age of 31 years ± 6.0 years. The overall prevalence of IBS among pregnant women was found to be 25.7%, with 13.5% at time of pregnancy and 12.2% after pregnancy. Pregnant women with IBS were significantly older compared to those without IBS (31.4 years vs. 30.7 years, p< 0.001). Comorbidities such as depression, anxiety, migraines, connective tissue disease or autoimmune disease demonstrated a higher prevalence of IBS. A lower prevalence of IBS was observed in women with BMI >40 and preterm birth (p< 0.001). None of the conditions in the severe obstetric comorbidity index were prevalent in our cohort and although some statistically significant differences were noted between the two groups (e.g. temporary tracheostomy), they were not clinically significant.

Discussion: We found prevalence of IBS was 25.7% among pregnant women with 13.5% at time of pregnancy and 12.2% after pregnancy. Psychological comorbidities such as depression and anxiety, migraines, and connective tissue or autoimmune disease were associated with IBS diagnosis among pregnant women. Limitations of this study include lack of demographic data such as race, enrichment in commercially insured individuals which impacts generalizability and lack of disease progressing observations. Future prospective studies are needed to identify specific risk factors that worsen IBS and for new-onset IBS postpartum.

	Total	Pregnant Patients, with IBS	Pregnant Patients, without IBS	P-value
Total # in cohort	77,517	19,902 (25.67)	57,615 (74.33)
IBS after pregnancy	9,449 (12.19)	9,449 (12.19)	NA
IBS at time of pregnancy	10,453 (13.48)	10,453 (13.48)	NA
Age, mean (SD)	30.85 (6.03)	31.35 (5.87)	30.68 (6.07)	< 0.001
Obstetric Comorbidities
Acute myocardial infarction	47 (0.06)	5 (0.03)	42 (0.07)	0.018
Aneurysm	8 (0.01)	3 (0.02)	5 (0.01)	0.444
Acute renal failure	246 (0.32)	54 (0.27)	192 (0.33)	0.181
Adult respiratory distress syndrome	307 (0.40)	61 (0.31)	246 (0.43)	0.020
Amniotic fluid embolism	18 (0.02)	3 (0.02)	15 (0.03)	0.382
Cardiac arrest/ventricular fibrillation	20 (0.03)	0 (0.00)	20 (0.03)	0.009
Conversion of cardiac rhythm	26 (0.03)	6 (0.03)	20 (0.03)	0.762
Disseminated intravascular coagulation	246 (0.32)	59 (0.30)	187 (0.32)	0.543
Eclampsia	203 (0.26)	43 (0.22)	160 (0.28)	0.142
Heart failure/arrest during surgery or procedure	3 (0.00)	0 (0.00)	3 (0.01)	0.309
Puerperal cerebrovascular disorders	176 (0.23)	37 (0.19)	139 (0.24)	0.157
Pulmonary edema / Acute heart failure	203 (0.26)	34 (0.17)	169 (0.29)	0.004
Severe anesthesia complications	16 (0.02)	1 (0.01)	15 (0.03)	0.075
Sepsis	663 (0.86)	137 (0.69)	526 (0.91)	0.003
Shock	80 (0.10)	19 (0.10)	61 (0.11)	0.693
Sickle cell disease with crisis	10 (0.01)	1 (0.01)	9 (0.02)	0.257
Air and thrombotic embolism	205 (0.26)	48 (0.24)	157 (0.27)	0.458
Blood products transfusion	0	0	0
Hysterectomy	19 (0.02)	7 (0.04)	12 (0.02)	0.265
Temporary tracheostomy	457 (0.59)	186 (0.93)	271 (0.47)	< 0.001
Ventilation	3 (0.00)	0 (0.00)	3 (0.01)	0.309
Other Comorbidities
Depression	11,107 (14.33)	3,811 (19.15)	7,296 (12.66)	< 0.001
Post-partum depression	2,192 (2.83)	589 (2.96)	1,603 (2.78)	0.194
Post-partum psychosis	41 (0.05)	9 (0.05)	32 (0.06)	0.585
Anxiety	27,686 (35.72)	8,235 (41.38)	19,451 (33.76)	< 0.001
Migraines	13,958 (18.01)	4,095 (20.58)	9,863(17.12)	< 0.001
Connective Tissue Disease or autoimmune disease	1,441 (1.86)	483 (2.43)	958 (1.66)	< 0.001
Preterm birth (< 37 weeks)	53,099 (68.50)	12,198 (61.29)	40,901 (70.99)	< 0.001
BMI >40	7,335 (9.46)	1,291 (6.49)	6,044 (10.49)	< 0.001

Disclosures:

Christie Lee Luo indicated no relevant financial relationships.

Yuying Luo indicated no relevant financial relationships.

Rachel Meislin indicated no relevant financial relationships.

Eunyoung Yang indicated no relevant financial relationships.

Xiaotao Zhang indicated no relevant financial relationships.

Christie Lee Luo, MPH¹, Yuying Luo, MD², Rachel Meislin, MD¹, Eunyoung Yang, MS¹, Xiaotao Zhang, MD, PhD¹. P0520 - IBS is Prevalent Amongst Pregnant Women, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.