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Digestive Diseases and Sciences

, Volume 60, Issue 9, pp 2750–2761 | Cite as

Inflammatory Bowel Disease Increases Risk of Adverse Pregnancy Outcomes: A Meta-Analysis

  • Aoibhlinn O’TooleEmail author
  • Ogochukwu Nwanne
  • Tracy Tomlinson
Original Article

Abstract

Background

Inflammatory bowel disease may place women at greater risk of adverse pregnancy outcomes.

Aim

To examine the association between inflammatory bowel disease and adverse pregnancy outcomes: preterm birth, small for gestational age (SGA) birth weight, congenital anomalies, and stillbirth.

Methods

We searched PubMed, EMBASE, the Cochrane Database of Systematic Reviews, and ClinicalTrials.gov for studies published from January 1980 through February 2014 and reference lists of relevant studies. We reviewed 1748 citations and identified studies evaluating outcomes of pregnancies complicated by inflammatory bowel disease. Selected studies evaluated one or more of the outcomes of interest, were in English, and gave sufficient details to perform meta-analysis. Three investigators independently reviewed articles for inclusion; discordant decisions were resolved by team review and consensus. Twenty-three studies that included 15,007 women with inflammatory bowel disease (5449 Crohn’s, 6559 ulcerative colitis) and 4,614,271 controls met selection criteria. Random-effects analytical methods were used to generate pooled odds ratios.

Results

We found an increased odds of the outcomes studied among women with inflammatory bowel disease compared with non-diseased controls: 1.85 for preterm birth (22 studies; 95 % confidence interval [CI] 1.67–2.05), 1.36 for SGA birth weight (13 studies; 95 % CI 1.16–1.60), 1.57 for stillbirth (10 studies; 95 % CI 1.03–2.38), and 1.29 for congenital anomalies (11 studies; 95 % CI 1.05–1.58). The latter result, however, may be unreliable secondary to publication bias.

Conclusion

Inflammatory bowel disease may increase the odds of adverse pregnancy outcomes.

Keywords

Pregnancy Ulcerative colitis Crohn’s disease Congenital anomalies Preterm birth Stillbirth 

Notes

Conflict of interest

None.

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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Aoibhlinn O’Toole
    • 1
    Email author
  • Ogochukwu Nwanne
    • 2
  • Tracy Tomlinson
    • 3
  1. 1.Department of GastroenterologyBeth Israel Deaconess Medical CenterBostonUSA
  2. 2.Institute of Human VirologyPent HouseGarki, AbujaNigeria
  3. 3.Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Women’s HealthSaint Louis University School of MedicineSt. LouisUSA

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