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Results from the Pregnancy in Inflammatory Bowel Disease and Neonatal Outcomes (PIANO) registry showed no correlation between biologic therapy and delayed wound healing after episiotomy, vaginal tear, or C-section.

Pregnancy and delivery come with many unique challenges and considerations for mothers with inflammatory bowel disease (IBD). Mothers with IBD, especially those on immunosuppressants, deliver by cesarean section (C-section) more frequently than the general population.1 This is partly driven by a fear of obstetrical perineal injury, which in a small percentage of women may impair the anal sphincter integrity and impact future continence.2 Delayed wound healing is an additional theoretical consideration if immunosuppressants are used. Despite the deeply ingrained concerns, the incidence of obstetrical perineal injury and wound healing in mothers with IBD are not well described in existing literature.

In this issue of Inflammatory Bowel Diseases, Lewin et al.3 described an analysis of the Pregnancy in Inflammatory Bowel Disease and Neonatal Outcomes (PIANO) registry on wound healing after vaginal tear, episiotomy, and C-section. The PIANO study is an ongoing prospective observational study examining patient-reported outcomes and has enrolled pregnant women with IBD in the United States since 2007. Several high-impact studies on maternal and offspring outcomes have been published based on the PIANO registry.4,5

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