The Influence of Disease Activity on Pregnancy Outcomes in Women with Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis

Min A. Kim, Young Han Kim, Jaeyoung Chun, Hye Sun Lee, Soo Jung Park, Jae Hee Cheon, Tae Il Kim, Won Ho Kim, Jae Jun Park

Research output: Contribution to journalReview articlepeer-review

2 Citations (Scopus)

Abstract

Background and Aims: Robust evidence regarding the impact of disease activity on pregnancy outcomes in women with inflammatory bowel disease [IBD] is crucial for both clinicians and patients in preparing a birth plan. We sought to perform a systematic review and meta-analysis to assess the pooled influences of disease activity on pregnancy outcomes in women with IBD. Methods: We searched MEDLINE, EMBASE and the COCHRANE library to identify articles comparing pregnancy outcomes between active and inactive IBD at the time of conception or during pregnancy. A meta-analysis was performed using a random-effects model to pool estimates and report odds ratios [ORs]. Results: A total of 28 studies were identified as eligible for the meta-analysis. In women with active IBD, the pooled ORs for low birth weight [LBW], preterm birth, small for gestational age [SGA], spontaneous abortion and stillbirths were respectively 3.81 (95% confidence interval [CI] 1.81-8.02), 2.42 [95% CI 1.74-3.35], 1.48 [95% CI 1.19-1.85], 1.87 [95% CI 1.17-3.0] and 2.27 [95% CI 1.03-5.04] compared to women with inactive IBD. In the subgroup analysis based on disease type, women with active ulcerative colitis had an increased risk of LBW, preterm birth and spontaneous abortion. Women with active Crohn's disease had a higher risk of preterm birth, SGA and spontaneous abortion. Conclusions: Active IBD during the periconception period and pregnancy is associated with an increased risk of adverse pregnancy outcomes. Our data suggest that pregnancy should be planned when the disease is quiescent, and continuous disease control is important even during pregnancy.

Original languageEnglish
Pages (from-to)719-732
Number of pages14
JournalJournal of Crohn's and Colitis
Volume15
Issue number5
DOIs
Publication statusPublished - 2021 May 4

Bibliographical note

Publisher Copyright:
© 2020 The Author(s) 2020. Published by Oxford University Press on behalf of European Crohn's and Colitis Organisation. All rights reserved. For permissions, please email: journals.permissions@oup.com.

All Science Journal Classification (ASJC) codes

  • Gastroenterology

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