8 MAINTENANCE THERAPY WITH AZATHIOPRINE (AZA)/6-MERCAPTOPURINE (6-MP) IN CROHN'S DISEASE (CD) REDUCES THE RISK OF RE-OPERATION PARTICULARLY IN SMOKERS

3 180 CD), actually fully evaluable, were compared to 294 pregnancies in HC and to 199 IBD non-pregnant pts.We found a similar rate of live births, spontaneous abortions and therapeutic abortions in IBD total and HC group, while the therapeutic abortion rate in CD pts compared to HC (3.9% vs 0.8% p=0.04) and in CD compared to UC pts (3.9% vs 0.5% p=0.03) was significantly higher.Mean birth weight was similar in IBD pts and in HC, but the number of low birth babies (<2500 gr) was higher in CD group (15.3% vs 8.7% p=0.004).The preterm delivery was similar in UC, CD and HC pregnancies (UC 9.6%, CD 13.3%, HC 9.6% p=n.s.).The rate of caesarean section was higher in CD pts than controls (41.4% vs 27.0% p=0.004).Congenital abnormalities were higher in CD than UC pts (5.0% vs 0.5% p=0.007).With regard to disease course we found that at conception 85.1% of the IBD pts were in remission.In 1.3% the onset of the disease occurred during gestation.During pregnancy a lower rate of UC pts maintained the remission compared to CD pts (58.9% vs 70.6% p=0.02).In post-partum period (6 months) the relapse was similar in UC and CD pts (14.2% vs 10.6%).Comparing the course of the disease in IBD pregnant and non-pregnant pts we found a greater relapse rate in CD pregnant vs CD non-pregnant (8.9% vs 1.2%).82.5% of the pts were under treatment at conception, 78.5% during pregnancy, 71.1% at conception and during gestational period.We evaluated the pregnancy outcomes in pts with active disease compared to pts in remission and in pts under treatment compared to pts without therapy.We didn' t find any significant difference with regard to treatment.The disease activity influenced the outcomes with regard to preterm delivery, therapeutic abortions and low birth weight.Conclusions: our preliminary data show that IBD influence the outcome of pregnancy with regard to therapeutic abortions, cesarean section, low birth weight and congenital abnormalities in CD but not in UC pts.Most IBD pts maintained therapy during gestation, without adverse influence on outcomes, but disease activity appeared to negatively influence the outcomes of pregnancy either in UC or in CD pts.In conclusions the pregnancy in IBD pts should be closely monitored.