{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T20:37:00Z","timestamp":1791405420753,"version":"4.3.3"},"reference-count":32,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2025,2,1]],"date-time":"2025-02-01T00:00:00Z","timestamp":1738368000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100010344","name":"Aage og Johanne Louis-Hansens Fond","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100010344","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,2,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background and Aims<\/jats:title>\n                  <jats:p>For pregnant women with perianal Crohn\u2019s disease (CD), major guidelines recommend delivery by caesarean section (c-section) for active disease, and that delivery mode be governed by obstetric indications for women with inactive disease. However, a significant gray zone exists between active versus inactive disease, such as for women who had a history of prior perianal surgery. We examined adverse maternal outcomes of vaginal delivery versus c-section in women with perianal CD and prior perianal surgeries.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We used the Danish national registries to collect information on singleton live births from 1997 through 2022 by mothers with CD and previous perianal surgery. Adverse postpartum maternal outcomes included new perianal or intestinal surgery within 12 months, hospital diagnosed infection or outpatient antibiotic prescription within 6 months, and major haemorrhage within 3 days. Adjusted odds ratios (aOR) were estimated in logistic regression models.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>There were 704 deliveries by women with CD and prior perianal surgery, including 245 vaginal deliveries (34.8%) and 459 c-sections (65.2%). Women who delivered vaginally versus by c-section had less new perianal surgery (aOR 0.47, 95% CI, 0.24-0.93) and no significant differences in intestinal CD surgery (aOR 0.87, 95% CI, 0.43-1.75), hospital diagnosed infection (aOR 0.50, 95% CI, 0.18-1.38), outpatient antibiotic prescription (aOR 0.92, 95% CI, 0.65-1.28), or major hemorrhage (aOR 0.79, 95% CI, 0.39-1.59).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Vaginal delivery was not associated with increased important adverse maternal outcomes in mothers with CD and prior perianal surgery.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ecco-jcc\/jjaf028","type":"journal-article","created":{"date-parts":[[2025,2,12]],"date-time":"2025-02-12T18:24:16Z","timestamp":1739384656000},"source":"Crossref","is-referenced-by-count":2,"title":["Adverse maternal outcomes after vaginal versus caesarean delivery in women with Crohn\u2019s disease and prior perianal surgery: a population-based study"],"prefix":"10.1093","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4735-4052","authenticated-orcid":false,"given":"Xiaocen","family":"Zhang","sequence":"first","affiliation":[{"name":"Gastroenterology and Hepatology, Tufts Medical Centre , Boston, MA ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9514-3033","authenticated-orcid":false,"given":"Bente Mertz","family":"N\u00f8rg\u00e5rd","sequence":"additional","affiliation":[{"name":"Gastroenterology and Hepatology, Tufts Medical Centre , Boston, MA ,","place":["United States"]},{"name":"Center for Clinical Epidemiology, Odense University\u00a0Hospital , Odense ,\u00a0","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olav Sivertsen","family":"Garvik","sequence":"additional","affiliation":[{"name":"Center for Clinical Epidemiology, Odense University\u00a0Hospital , Odense ,\u00a0","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7634-6812","authenticated-orcid":false,"given":"Jan","family":"Nielsen","sequence":"additional","affiliation":[{"name":"Center for Clinical Epidemiology, Odense University\u00a0Hospital , Odense ,\u00a0","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mette Louise","family":"Andersen","sequence":"additional","affiliation":[{"name":"Center for Clinical Epidemiology, Odense University\u00a0Hospital , Odense ,\u00a0","place":["Denmark"]},{"name":"Department of Gynaecology and Obstetrics, University Hospital of Southern Denmark , Esbjerg ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonia","family":"Friedman","sequence":"additional","affiliation":[{"name":"Gastroenterology and Hepatology, Tufts Medical Centre , Boston, MA ,","place":["United States"]},{"name":"Center for Clinical Epidemiology, Odense University\u00a0Hospital , Odense ,\u00a0","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,2,12]]},"reference":[{"key":"2025030420570428200_CIT0001","doi-asserted-by":"crossref","first-page":"1477","DOI":"10.1093\/ibd\/izab287","article-title":"Epidemiology and natural history of perianal crohn\u2019s disease: a systematic review and meta-analysis of population-based cohorts","volume":"28","author":"Tsai","year":"2022","journal-title":"Inflamm Bowel Dis."},{"key":"2025030420570428200_CIT0002","doi-asserted-by":"crossref","first-page":"1875","DOI":"10.14309\/ajg.0000000000002732","article-title":"Does surgery prior to pregnancy in women with inflammatory bowel disease increase the risk of adverse maternal and fetal outcomes? A danish national cohort study","volume":"119","author":"Friedman","year":"2022","journal-title":"Am Coll Gastroenterol."},{"key":"2025030420570428200_CIT0003","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12955-020-01622-7","article-title":"Burden of disease and adaptation to life in patients with Crohn\u2019s perianal fistula: a qualitative exploration","volume":"18","author":"Adegbola","year":"2020","journal-title":"Health Qual Life Outcomes."},{"key":"2025030420570428200_CIT0004","doi-asserted-by":"crossref","first-page":"i36","DOI":"10.1136\/gut.2005.081950c","article-title":"European evidence based consensus on the diagnosis and management of Crohn\u2019s disease: special situations","volume":"55","author":"Caprilli","year":"2006","journal-title":"Gut."},{"key":"2025030420570428200_CIT0005","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1093\/ecco-jcc\/jju006","article-title":"The second European evidenced-based consensus on reproduction and pregnancy 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