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Low-Dose Aspirin Use Does Not Increase Disease Activity in Pregnant Patients with Inflammatory Bowel Disease

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Abstract

Background

The adverse effects of non-steroidal anti-inflammatory (NSAID) drugs on the gastrointestinal system are well recognized, but the effect of NSAID use on disease activity patients with inflammatory bowel disease (IBD) remains unresolved. Low-dose aspirin (LDA) is recommended for all pregnant patients with risk factors for developing preeclampsia, including autoimmune conditions. As recognition of risk factors for preeclampsia improves, the preventative use of LDA is likely to increase.

Aims

To investigate if LDA use for prevention of preeclampsia increases the risk of disease activity in pregnant women with IBD.

Methods

Single-center retrospective cohort study of pregnant patients with IBD who delivered from 2012 to 2020, comparing those with and without LDA use. Primary outcome was odds of clinical IBD activity in patients in remission at time of conception. Secondary outcomes were rate of elevated inflammatory biomarkers, defined as C-reactive protein > 5 ug/mL or fecal calprotectin > 250 ug/g, and rate of preeclampsia. Univariate analyses tested for associations.

Results

Patients taking LDA were older (p = 0.003) and more likely to have chronic hypertension (p = 0.002), to have undergone in vitro fertilization (p < 0.001), and to be on biologics (p = 0.03). Among patients in remission at conception, there was no difference in clinical disease activity or biomarker elevation during pregnancy based on LDA use (OR 1.27, 95% CI [0.55–2.94], p = 0.6). Rates of preeclampsia were similar between groups.

Conclusion

LDA use for preeclampsia prevention did not increase the incidence of disease activity in pregnant patients with IBD.

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Funding

No funds, grants or other support was received.

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Authors and Affiliations

  1. Department of Obstetrics, Gynecology and Reproductive Science, Mount Sinai Health System & Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Chelsea A. DeBolt, Manasa G. Rao, Shaelyn Johnson, Rachel Meislin, Jill Berkin, Angela Bianco & Maria Teresa Mella

  2. Departments of Medicine and Pediatrics, Icahn School of Medicine at Mount Sinai, Susan and Leonard Feinstein Inflammatory Bowel Diseases Clinical Center, 1 Gustave Levy Place, Annenberg 5, New York, NY, 10029, USA

    Zoë S. Gottlieb & Marla C. Dubinsky

  3. Department of Obstetrics and Gynecology, NYU Langone Health, NYU Langone Hospital Long Island, NYU Long Island School of Medicine, Mineola, NY, USA

    Patricia Rekawek

  4. Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Richa Deshpande

Authors
  1. Chelsea A. DeBolt
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  2. Zoë S. Gottlieb
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  3. Manasa G. Rao
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  4. Shaelyn Johnson
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  5. Patricia Rekawek
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  7. Rachel Meislin
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  8. Jill Berkin
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  9. Angela Bianco
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  10. Maria Teresa Mella
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  11. Marla C. Dubinsky
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Contributions

CAD and MTM: devised the study and performed data collection and analyses. The manuscript was written by CAD and ZSG and edited by MTM and MCD. All other authors assisted with data collection and reviewed the article in full.

Corresponding author

Correspondence to Zoë S. Gottlieb.

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Conflict of interest

MCD is a consultant for the following: Abbvie, Abivax, Arena Pharmaceuticals, Astra Zeneca, Boehringer Ingelheim International GmbH, Bristol-Meyer Squibb, Eli Lilly and Company, F. Hoffmann-La Roche Ltd, Genentech Inc, Gilead, Janssen Pharmaceuticals, Merck, Pfizer Inc, Prometheus Biosciences, Takeda Pharmaceuticals. The authors otherwise have no relevant financial or non-financial interests to disclose.

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DeBolt, C.A., Gottlieb, Z.S., Rao, M.G. et al. Low-Dose Aspirin Use Does Not Increase Disease Activity in Pregnant Patients with Inflammatory Bowel Disease. Dig Dis Sci (2024). https://doi.org/10.1007/s10620-024-08364-2

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  • DOI: https://doi.org/10.1007/s10620-024-08364-2

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