3 - Maternal and Fetal Outcomes in Patients With Eosinophilic Esophagitis on Steroids

Award: ACG/Radhika Srinivasan Gender-Based Research Award

Julton Tomanguillo Chumbe, MD, Frank Annie, PhD, Mark Ayoub, MD, Lauren Searls, DO, Vishnu Naravadi, MD
Charleston Area Medical Center, West Virginia State University Charleston Division, Charleston, WV

Introduction: Eosinophilic esophagitis (EoE) is a pathology that has been increasing in incidence in recent years, especially among woman of reproductive age. There is a lack of safety data among pregnant patients with EoE and the use of steroids. The limited data has been extrapolated from studies of asthmatic pregnant patients. Therefore, there is a big need to provide safety and outcomes data during pregnancy and post-delivery fetus. The main objective of this study is to evaluate maternal and fetal outcomes in patients on active treatment for EoE with steroids.

Methods: Adult pregnant patients 18 years and older with the diagnosis of EoE were identified using TriNetX between January 2011 and December 2022. The TriNetx Global Collaborative Network includes a total of 101 different health care organizations from 14 different countries. Patients were divided into two cohorts; patients who were on fluticasone and budesonide and patients not on steroids. We compared the rate of spontaneous abortion, placenta previa, pre-eclampsia, premature delivery, HELLP syndrome, eclampsia, hyperemesis gravidarum, and major congenital abnormalities between propensity score matched (PSM) pairs of patients.

Results: A total of 1,093 female patients of childbearing age were included in the analysis. Of those, 76.5% (n=836) were not on any active treatment with steroids, and 23.5% (n=257) were on steroids. The pre-PSM data suggest that patients on steroids had on average the same age (34.3 +/- 6.0 vs 34.3 +/- 6.2, P=0.951), gestational age (16.3 +/- 0.5 vs 15.2 +/- 1.9, P=0.125), and key comorbidities such as diabetes mellitus (3.9% vs 5.0%, P=0.456), and hypertension (12.5% vs 11.7%, P=0.752), compared to patients not on steroids. Subsequently, two PSM cohorts were created using a 1:1 model (249/249). The use of budesonide or fluticasone were not significantly associated with spontaneous abortion (4.0% vs 5.22%, P=0.522), placenta previa (4.0% vs 4.0%, P=1.00), pre-eclampsia (4.0% vs 4.8%, P= 0.663), premature delivery (4.0% vs 4.0%, P=1.00), HELLP Syndrome (4.0% vs 4.0%, P=1.00), eclampsia (0 vs 0), hyperemesis gravidarum (4.0% vs 4.0%, P=1.00), or major congenital abnormalities (6.4% vs 6.0%, P=0.853), when compared to patients not on any steroid treatment.

Discussion: The use of inhaled steroids in pregnant patients with EoE did not adversely affect maternal and fetal outcomes.


Disclosures:


Julton Tomanguillo Chumbe, MD, Frank Annie, PhD, Mark Ayoub, MD, Lauren Searls, DO, Vishnu Naravadi, MD, 3, Maternal and Fetal Outcomes in Patients With Eosinophilic Esophagitis on Steroids, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.