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Systematic review with meta-analysis: risk of adverse pregnancy-related outcomes in inflammatory bowel disease.
Alimentary Pharmacology & Therapeutics ( IF 7.6 ) Pub Date : 2020-01-07 , DOI: 10.1111/apt.15587 Parul Tandon 1, 2 , Vivek Govardhanam 2 , Kristel Leung 1, 2 , Cynthia Maxwell 3 , Vivian Huang 1, 2
Alimentary Pharmacology & Therapeutics ( IF 7.6 ) Pub Date : 2020-01-07 , DOI: 10.1111/apt.15587 Parul Tandon 1, 2 , Vivek Govardhanam 2 , Kristel Leung 1, 2 , Cynthia Maxwell 3 , Vivian Huang 1, 2
Affiliation
BACKGROUND
The effect of inflammatory bowel disease (IBD) on pregnancy-related outcomes remains unknown.
AIM
To determine the risk of adverse maternal, placental and obstetric outcomes in IBD METHODS: We searched Medline, Embase and Cochrane library through May 2019 for studies reporting adverse maternal, placental and obstetric outcomes in patients with IBD. Odds ratios (OR) with 95% confidence intervals (CI) were calculated for these outcomes in patients with IBD compared to healthy controls.
RESULTS
Fifty-three studies were included (7917 IBD pregnancies and 3253 healthy control pregnancies). Caesarean delivery was more common in patients with IBD compared to healthy controls (OR 1.79, 95% CI, 1.16-2.77). This remained significant for UC (OR 1.80, 95% CI, 1.21-2.90) but not CD (OR 1.48, 95% CI, 0.94-2.34). Similarly, gestational diabetes occurred more commonly in IBD (OR 2.96, 95% CI, 1.47-5.98). The incidences of placental diseases were 2.0% (95% CI, 0.9%-3.1%) for pre-eclampsia, 3.3% (95% CI, 0%-7.2%) for placental abruption, 0.5% (95% CI, 0.2%-0.9%) for placenta previa and 0.3% (95% CI, 0%-0.5%) for chorioamnionitis. Patients with IBD were more likely to experience preterm prelabour rupture of membranes (OR 12.10, 95% CI, 2.15-67.98), but not early pregnancy loss (OR 1.63, 95% CI 0.49-5.43). Anti-tumour necrosis factor therapy was not associated with chorioamnionitis (OR 1.12, 95% CI, 0.16-7.67), early pregnancy loss (OR 1.49, 95% CI, 0.83-2.64) or placenta previa (OR 1.58, 95% CI, 0.30-8.47).
CONCLUSIONS
Gestational diabetes and preterm prelabour rupture of membranes occurs more commonly in patients with IBD, although the incidence of placental diseases remains low.
中文翻译：
荟萃分析的系统评价：炎性肠病中与妊娠相关的不良后果的风险。
背景技术炎性肠病（IBD）对与妊娠相关的结果的影响仍然未知。目的确定IBD中孕妇，胎盘和产科预后不良的风险。方法：我们搜索了截至2019年5月的Medline，Embase和Cochrane库，以研究报告IBD患者孕妇，胎盘和产科预后不良的研究。与健康对照组相比，IBD患者中这些结局的赔率（OR）和95％置信区间（CI）被计算出来。结果纳入了53项研究（7917例IBD妊娠和3253例健康对照妊娠）。与健康对照组相比，IBD患者剖腹产更为常见（OR 1.79、95％CI，1.16-2.77）。这对于UC（OR 1.80，95％CI，1.21-2.90）仍然很重要，而对于CD（OR 1.48，95％CI，0.94-2.34）则不明显。同样，妊娠糖尿病多见于IBD（OR 2.96，95％CI，1.47-5.98）。子痫前期的胎盘疾病发生率为2.0％（95％CI，0.9％-3.1％），胎盘早剥的发生率为3.3％（95％CI，0％-7.2％），0.5％（95％CI，0.2％） -0.9％）（前置尿素）和0.3％（95％CI，0％-0.5％）绒毛膜羊膜炎。IBD患者更有可能发生早产胎膜破裂（OR 12.10，95％CI，2.15-67.98），但没有早期流产破裂（OR 1.63，95％CI 0.49-5.43）。抗肿瘤坏死因子疗法与绒毛膜羊膜炎（OR 1.12，95％CI，0.16-7.67），早孕流失（OR 1.49，95％CI，0.83-2.64）或前置胎盘（OR 1.58，95％CI， 0.30-8.47）。结论妊娠糖尿病和早产早产膜破裂在IBD患者中更常见，
更新日期：2020-01-08
中文翻译：
荟萃分析的系统评价：炎性肠病中与妊娠相关的不良后果的风险。
背景技术炎性肠病（IBD）对与妊娠相关的结果的影响仍然未知。目的确定IBD中孕妇，胎盘和产科预后不良的风险。方法：我们搜索了截至2019年5月的Medline，Embase和Cochrane库，以研究报告IBD患者孕妇，胎盘和产科预后不良的研究。与健康对照组相比，IBD患者中这些结局的赔率（OR）和95％置信区间（CI）被计算出来。结果纳入了53项研究（7917例IBD妊娠和3253例健康对照妊娠）。与健康对照组相比，IBD患者剖腹产更为常见（OR 1.79、95％CI，1.16-2.77）。这对于UC（OR 1.80，95％CI，1.21-2.90）仍然很重要，而对于CD（OR 1.48，95％CI，0.94-2.34）则不明显。同样，妊娠糖尿病多见于IBD（OR 2.96，95％CI，1.47-5.98）。子痫前期的胎盘疾病发生率为2.0％（95％CI，0.9％-3.1％），胎盘早剥的发生率为3.3％（95％CI，0％-7.2％），0.5％（95％CI，0.2％） -0.9％）（前置尿素）和0.3％（95％CI，0％-0.5％）绒毛膜羊膜炎。IBD患者更有可能发生早产胎膜破裂（OR 12.10，95％CI，2.15-67.98），但没有早期流产破裂（OR 1.63，95％CI 0.49-5.43）。抗肿瘤坏死因子疗法与绒毛膜羊膜炎（OR 1.12，95％CI，0.16-7.67），早孕流失（OR 1.49，95％CI，0.83-2.64）或前置胎盘（OR 1.58，95％CI， 0.30-8.47）。结论妊娠糖尿病和早产早产膜破裂在IBD患者中更常见，
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