P2636 - Unveiling the Postpartum Peril: Assessing Inflammatory Bowel Disease's Impact on Hospital Readmissions

Sanket Basida, MD¹, Neel Vora, MBBS², Muhammad Nadeem. Yousaf, MD³, Dushyant S. Dahiya, MD⁴, Bhanu Siva Mohan Pinnam, MD⁵, Madhav Changela, MD⁶, Ebubekir Daglilar, MD^7
1University of Missouri School of Medicine, Columbia, MO; ²B.J. Medical College, Rajkot, Gujarat, India; ³University of Missouri Health Care, Columbia, MO; ⁴The University of Kansas School of Medicine, Kansas City, KS; ⁵John H. Stroger, Jr. Hospital of Cook County, Chicago, IL; ⁶One Brooklyn Health-Interfaith Medical Center, Brooklyn, NY; ⁷Charleston Area Medical Center, Charleston, WV

Introduction: Inflammatory Bowel Disease (IBD), including Crohn’s disease (CD) and Ulcerative Colitis (UC) not only poses a risk during conception and the intrapartum period, but it can also complicate the post-partum period. Although there has been conflicting evidence regarding the impact of IBD on the post-partum period, the literature is scarce. While some studies have shown significant risk, others show that pregnancy might influence the course of IBD positively. The objective of this study is to evaluate how IBD affects hospital readmissions in the postpartum period

Methods: Adults hospitalized from January 2016 to December 2020 for birthing/delivery and underlying IBD in the nationwide readmission database (NRD) were captured using ICD-10 diagnosis and procedure codes (International Classification of Diseases, tenth edition). The primary outcome was readmission rates in the post-partum period. Secondary outcomes were causes of readmission. We used the Wilcoxon Rank sum test and Chi-square tests for analysis. Multivariate logistic regression models were used where appropriate

Results: A total of 14,900,000 post-partum patients, where 14,862,252 patients did not have IBD, 22,451 had CD, and 15,297 had UC. The mean ages were 29-31 years in all three groups. The 30-day readmission rate in non-IBD patients was 1.36% compared to 1.9% in UC, and 2.28% in CD (p< 0.001). At 90 days, CD (aOR:1.92, p< 0.001) and UC (aOR:1.6, p< 0.001) had a higher risk of readmission compared with non-IBD patients. At 6 months, CD (aOR:2.46, p< 0.001) and UC (aOR:2.04, p< 0.001) patients were at least twice more likely to be readmitted compared with non-IBD patients. The most common causes of readmission in IBD patients in the post-partum period were IBD flare, Endometritis following delivery, Severe pre-eclampsia complicating the puerperium, and sepsis.

Discussion: In conclusion, both CD and UC patients demonstrated notably higher readmission rates compared to non-IBD patients, with CD patients at the greatest risk. The increased risk of readmission in postpartum IBD patients is multifactorial, involving disease-specific factors, obstetric complications, medication adjustments, and psychosocial stressors. Understanding these mechanisms is crucial for optimizing management strategies and improving outcomes for women with IBD during the vulnerable postpartum period.


Disclosures:


Sanket Basida, MD¹, Neel Vora, MBBS², Muhammad Nadeem. Yousaf, MD³, Dushyant S. Dahiya, MD⁴, Bhanu Siva Mohan Pinnam, MD⁵, Madhav Changela, MD⁶, Ebubekir Daglilar, MD⁷. P2636 - Unveiling the Postpartum Peril: Assessing Inflammatory Bowel Disease's Impact on Hospital Readmissions, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.