The mode of delivery does not influence the occurrence of post-partum perianal disease flares in patients with inflammatory bowel disease.

"Declarations Competing interestsDr. Holubar serves as a consultant for Shionogi, Takeda, and Guidepoint and has research funding from the Crohn’s & Colitis Foundation and American Society of Colon&Rectal Surgeons. Dr. Lightner serves as a consultant for Takeda, Ossium, Mesoblast and Boomerang. Dr. Hull, Dr. Lipman, Dr. Steele, Dr. Aykun, Dr. Maspero, Dr. Otero-Piñeiro declare no conflict of interest. Ethics approval and consent to participateCleveland Clinic’s Institutional Review Board (IRB) - Ethics Committee consists of members including both staff-level and resident physicians, administrative personnel, nursing personnel, and non-affiliated lay people to represent the community. The fundamental purpose of the IRB is for the protection of human subjects in research. The IRB committee reviews and monitors research projects according to federal regulations. All consecutive eligible female patients with IBD who delivered either vaginally or by C-section were identified in the Cleveland Clinic database from 1997 to 2022 following ethics approval by the Cleveland Clinic Institutional Review Board. All the patients signed informed consent. The study was performed in accordance with relevant guidelines and regulations. Consent for publicationNot applicable. Competing interests Dr. Holubar serves as a consultant for Shionogi, Takeda, and Guidepoint and has research funding from the Crohn’s & Colitis Foundation and American Society of Colon&Rectal Surgeons. Dr. Lightner serves as a consultant for Takeda, Ossium, Mesoblast and Boomerang. Dr. Hull, Dr. Lipman, Dr. Steele, Dr. Aykun, Dr. Maspero, Dr. Otero-Piñeiro declare no conflict of interest."

"Funding No founding support."