Pregnancy With a Stoma is Feasible, Though Associated With Manageable Complications

Dianne Gelien Bouwknegt; Albertina Henrika Chantall van der Weide; Gerard Dijkstra; Rogier Leon Goetgebuer; Lotte Oldenburg; Willemijn Alexandra van Dop; Meike Madeleine Catherine Hirdes; Jelmer Riemer Prins; Froukje Jantien Hoogenboom; Christien Janneke van der Woude; Marijn Caroline Visschedijk

doi:10.1093/ibd/izae301

Pregnancy With a Stoma is Feasible, Though Associated With Manageable Complications

Inflamm Bowel Dis. 2025 Jan 3:izae301. doi: 10.1093/ibd/izae301. Online ahead of print.

Affiliations

¹ Department of Gastroenterology and Hepatology, University Medical Center Groningen, University of Groningen, 9713GZ, Groningen, The Netherlands.
² Department of Gastroenterology and Hepatology, Amsterdam University Medical Center, 1105AZ, Amsterdam, The Netherlands.
³ Department of Gastroenterology and Hepatology, Radboud University Medical Center, 6525GA, Nijmegen, The Netherlands.
⁴ Department of Gastroenterology and Hepatology, University Medical Center Utrecht, 3584CX, Utrecht, The Netherlands.
⁵ Department of Obstetrics and Gynaecology, University Medical Center Groningen, University of Groningen, 9713GZ, Groningen, The Netherlands.
⁶ Department of Colorectal Surgery, University Medical Center Groningen, University of Groningen, 9713GZ, Groningen, The Netherlands.

PMID: 39756433
DOI: 10.1093/ibd/izae301

Abstract

Background: Inflammatory bowel disease (IBD) is often diagnosed in young adults, and therefore frequently coincides with pregnancy. Patients may require surgery that includes (temporary) stoma placement. Literature on the occurrence of stoma-complications during pregnancy and the effect on pregnancy outcomes is limited. To evaluate stoma- complications peri- and postpartum, a retrospective study was performed in women who were pregnant while having a stoma.

Methods: This multicentre cohort and survey study included all pregnant patients with IBD and a stoma who delivered between 2016 and 2023 from 5 Dutch university hospitals. Stoma-complications and pregnancy outcomes were retrospectively collected from electronic patient files. A questionnaire assessed patient-reported complications and long-term stoma-related complaints.

Results: In total, 50 patients were included (median age at conception 31.0 years; 55.2% Crohn's disease and 44.8% ulcerative colitis), comprising 67 pregnancies, 5 of which ended in pregnancy loss. Stoma complications occurred in 44 full-term pregnancies (71.0%), most commonly obstruction (35.5%) and decreased output (29.0%). Surgery was required in four pregnancies due to obstruction (n = 3) and prolapse (n = 2). In the first-year postpartum, 7 patients required surgery for stoma-complications. Amongst 29 women who completed the questionnaire, 10 (34.5%) reported unresolved complications 6 months postpartum. Cesarean sections were performed in 31 (50.0%) pregnancies. Adverse pregnancy outcomes included prematurity (n = 9, 14.5%), low birth weight (n = 9, 14.5%), and dysmaturity (n = 5, 8.1%).

Conclusions: Pregnancy with a stoma is feasible, though manageable complications often occur. Counseling before pregnancy and close monitoring of symptoms during pregnancy and postpartum are essential for women with IBD and a stoma.

Keywords: clinical trials; inflammatory bowel disease; pregnancy; stoma; surgery.

Plain language summary

The treatment of inflammatory bowel disease may include stoma-formation. In this cohort of pregnant patients with a stoma, 71.0% experienced a stoma-related complication. Obstruction was the most common problem. Most symptoms could be successfully managed conservatively.