P215 The influence of disease activity on birth outcomes in patients with inflammatory bowel disease: Meta- analysis
J. J. Park*1, H. J. Kim2, M.-A. Kim3
1Gangnam Severance Hospital, Yonsei University College of Medicine, Internal Medicine, Seoul, South Korea, 2Korea University College of Medicine, Preventive Medicine, Seoul, South Korea, 3Gangnam Severance Hospital, Yonsei University College of Medicine, Obstetrics and Gynaecology, Seoul, South Korea
There is a concern that active disease during pregnancy in women with inflammatory bowel disease (IBD) may be associated with adverse birth outcomes; however, data dealing this topic have yielded conflicting results. We performed a systematic review and meta-analysis to evaluate the effect of disease activity at the time of conception or during pregnancy on birth outcomes in women with IBD.
A systematic literature search of PubMed, EMBASE, Cochrane Library, and Korean Med was conducted to identify studies that investigated the birth outcomes amongst pregnant women with IBD based on clinical disease activity. Disease activity was assessed at conception or during pregnancy. Various birth outcomes including premature birth, low birth weight, small for gestational age, spontaneous abortion, threatened abortion, still birth, Caesarean section, and chromosomal abnormality were measured. If significant heterogeneity was present, a random-effects model was used for data pooling.
Eleven studies with 4 739 pregnant women with IBD were included. Regarding disease type, 10 studies contained patients with Crohn’s disease (n = 2 191), and 6 studies contained patients with ulcerative colitis (n = 2548). In women with IBD having active disease, the pooled odd ratios (ORs) for premature birth (OR 2.19, 95% CI: 1.72–2.80), small for gestational age (OR 1.86, 95% CI: 1.14–3.03), low birth weight (OR 2.21, 95% CI: 1.01–4.84), still birth (OR 2.38, 95% CI: 1.03–5.51), and threatened abortion (OR 2.41, 95% CI: 1.08–5.36) were significantly higher than those of women with IBD in remission
Active disease at conception or during pregnancy in women with IBD was associated with adverse birth outcomes including premature birth, small for gestational age, low birth weight, stillbirth, and threatened abortion. Maintenance of remission at pre-conceptual phase and throughout pregnancy is crucial for better pregnancy outcomes in these patients.