Perinatal outcome in women with inflammatory bowel disease.

INTRODUCTION: Inflammatory bowel disease (IBD) is a lifelong, chronic inflammatory condition of the gastrointestinal tract. IBD morbidity rate in Europe has been steadily growing for the last six decades. Women with IBD are often diagnosed during the childbearing years, which makes the influence of the disease on pregnancy and birth outcomes an important clinical issue. OBJECTIVES: The aim of the study was to estimate the influence of the IBD process among pregnant women on maternal, fetal and neonatal parameters. MATERIAL AND METHODS: A retrospective analysis of data on patients suffering from IBD, diagnosed before pregnancy who were admitted to the Department of Perinatology and Gynecology Polish Mother's Memorial Hospital Research Institute for delivery between 2009-2013, was conducted. IBD was diagnosed in 10 cases. The control group consisted of 10 healthy pregnant women near delivery RESULTS: IBD activity status at conception in women receiving continuous mesalazine treatment does not correlate with gestational age, birth weight, Apgar score or maternal platelet count at delivery in comparison to controls. IBD patients under mesalazine management had lower: i) maternal body mass index and platelet count, ii) neonatal birth weight and Apgar score as compared to controls. However, no impact of IBD on the frequency of congenital anomalies was noted. CONCLUSIONS: To the best of our knowledge, this has been the first study conducted among pregnant women with IBD in Poland. The analysis demonstrates that pharmacological treatment has a deteriorating influence on maternal weight gain in pregnancy as well as production and activity of platelets. Moreover, it diminishes fetal growth and worsens short-term neonatal condition. Further studies with larger sample size are necessary but the rarity of this complication limits the possibility of research therapeutic perspectives.

Epidemiological models for breast cancer risk estimation.

Breast cancer is the most common malignancy affecting women worldwide. Effective prevention and screening are only possible if there is precise risk prediction for cancer in an individual patient. Mathematical models for estimation of breast cancer risk were developed on the basis of epidemiological studies. It is possible to identify women at high risk for this disease using patient history data and the analysis of various demographic and hereditary factors. The Gail risk model, originally developed in the United States to selectively identify patients for breast cancer chemoprevention studies, remains to be the most widely used and properly validated. The Cuzick-Tyrer model is more advanced and was developed for the International Breast Intervention Study (IBIS-1). It incorporates the assessment of additional hereditary factors, body mass index, menopausal status and hormone replacement therapy use. Genetic models aiming at calculating individual risk for BRCA1 and BRCA2 mutation carrier-state have also been designed. In this review we discuss the usefulness of various risk estimation models and their possible application for breast cancer prophylaxis.