{
  "abstract": "Introduction Active inflammatory bowel disease (IBD) during pregnancy is associated with an increased risk of adverse outcomes. Disparities in healthcare access and outcomes across ethnic groups remain underexplored in IBD pregnancy care.Methods A retrospective cohort study included all pregnancies managed via a tertiary hospital joint IBD–Antenatal Clinic between August 2020 and July 2025. Patients were categorised into:White Ethnic Background (WEB: White British, Irish, and European)Minority Ethnic Background (MEB: Bangladeshi, Pakistani, Sri Lankan, Indian, Black, Mixed, and ‘other’ background).Disease activity was defined using symptoms and objective biomarkers (C-reactive protein/ Faecal Calprotectin) to inform a Physician Global Assessment. Patients were stratified as having ‘active disease’ or being in ‘remission’.Results A total of 243 patients were included (MEB 108, WEB 135). MEB patients had a lower mean maternal age (31.9 vs 33.9 years, p <0.001) and shorter median (IQR) disease duration (7 [3.0-11.0] years vs 9.5 [5.0-15.0], p=0.002). MEB women were less likely to be nulliparous (43.5% vs 61.5%, p=0.003) and more likely to have had 2 or more previous pregnancies (27.8% vs 11.9%, p=0.003).In the 6 months prior to conception, rates of active disease were similar between the two groups (MEB 26.7% vs WEB 21.1%, p=0.311). Despite this at conception, a higher proportion of women in the MEB group had active disease compared with the WEB group (25.0% vs 16.3%, p=0.213). During pregnancy, the proportion of women with active disease increased markedly in the MEB cohort (51.5% vs 30.1%, p=0.001).Despite similar treatment patterns at conception and in response to active disease, women from a MEB experienced higher rates of adverse pregnancy outcomes, including gestational diabetes (GDM) (17.2% vs 5.9%, p=0.019), pre-term birth (13.6% vs 1.4%, p=0.006), and NICU admission (12.4% vs 2.9%, p=0.030).On multivariable analysis, after adjustment for maternal age, BMI at conception and disease activity during pregnancy, MEB remained independently associated with increased odds of GDM (aOR 3.31, 95% CI 1.10–9.97; p=0.033), pre-term birth (aOR 14.75, 95% CI 1.78–121.98; p=0.013), and NICU admission (aOR 7.94, 95% CI 1.52–41.29; p=0.014).Conclusions This study highlights a disproportionate burden of active disease and adverse outcomes among patients from minority ethnic backgrounds with IBD. Disparities persist despite equivalent access to treatments and joint IBD–antenatal care, suggesting that additional socioeconomic, cultural, or systemic barriers may contribute. A targeted approach addressing disparities through pre-conception counselling, earlier engagement with services, tight disease control and tailored multidisciplinary support is essential to improving equity in IBD pregnancy care.",
  "authors": [
    {
      "affiliations": [
        "Barts Health NHS Trust, London, United Kingdom"
      ],
      "name": "Krishna Shah"
    },
    {
      "affiliations": [
        "Barts Health NHS Trust, London, United Kingdom",
        "Blizzard Institute, Queen Mary University London, London, United Kingdom"
      ],
      "name": "James O Lindsay"
    },
    {
      "affiliations": [
        "Barts Health NHS Trust, London, United Kingdom",
        "Blizzard Institute, Queen Mary University London, London, United Kingdom"
      ],
      "name": "Gareth Parkes"
    },
    {
      "affiliations": [
        "Barts Health NHS Trust, London, United Kingdom"
      ],
      "name": "Mandeep Kaur Kaler"
    },
    {
      "affiliations": [
        "Barts Health NHS Trust, London, United Kingdom",
        "Blizzard Institute, Queen Mary University London, London, United Kingdom"
      ],
      "name": "Klaartje Kok"
    }
  ],
  "title": "FP15 Ethnic disparities in disease activity and maternal-neonatal outcomes in pregnant women with inflammatory bowel disease",
  "uid": "13c6bfd7-90b6-543a-8b7b-7c8a421eec08"
}