Evaluating the impact of inflammatory bowel disease on mental health during pregnancy: a retrospective survey study.

BACKGROUND: Individuals with inflammatory bowel disease (IBD) experience mental health disorders at rates 1.5-2 times higher than the general population. Many are affected during major life stages such as pregnancy, yet data on how IBD influences anxiety and depression in pregnancy remain limited. METHODS: This retrospective survey study included patients from the "Preconception and Pregnancy in IBD" clinic who conceived before January 1, 2022. Standardized pre-visit surveys assessed anxiety (general anxiety disorder-7 [GAD-7]), depression (patient health questionnaire-9 [PHQ-9]), and IBD activity using pMayo6 for ulcerative colitis (UC) and mHBI for Crohn's disease (CD). Demographic variables included age, marital and employment status, smoking, alcohol and cannabis use, prior anxiety/depression diagnoses, IBD subtype, surgical history, and medication use. Linear regression models evaluated associations between disease activity and mental health outcomes, adjusting for medication type and stratifying by trimester and IBD subtype. RESULTS: Ninety-four patients were included: 42 patients had UC (44.7%), and 52 patients had CD (55.3%). Median age was 32 (interquartile range [IQR] 31-35.8) for UC and 32.7 (IQR 30-35.2) for CD. Active UC in the second trimester was associated with significantly higher anxiety (P = 0.034) and depression (P = 0.022) scores compared to those with inactive UC. In the third trimester, this pattern persisted, with active UC again associated with elevated anxiety (P = 0.030) and depression (P = 0.027) scores. Active CD in the second trimester was significantly associated with higher anxiety (P = 0.024) and depression scores (P = 0.021) compared to those in remission. CONCLUSIONS: Active IBD during pregnancy is significantly associated with increased anxiety and depression. Multidisciplinary care, including mental health support, is imperative for pregnant people with IBD.