부산대학교 도서관

Summary: 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. [ABSTRACT FROM AUTHOR]