The rate of exacerbation of inflammatory bowel disease during pregnancy varies in the published literature.
Dr Abhyankar and colleagues from Massachussetts, USA performed a systematic review and meta-analysis of the effects of disease activity at conception on disease course during pregnancy in women with inflammatory bowel disease.
Published studies and abstracts from standard sources were screened for appropriate studies.
Data were pooled and analysed using funnel and forest plots.
Quality assessment scores were given using GRADE criteria.
|14 studies were eligible for inclusion|
|Alimentary Pharmacology & Therapeutics|
The doctors reported that 14 studies were eligible for inclusion, of which 10 studies contained patients with ulcerative colitis, and 6 studies contained patients with Crohn's disease.
In patients with ulcerative colitis there was a significantly higher risk ratio of active disease during pregnancy in patients who commenced pregnancy with active disease, when compared with those in remission at conception.
This risk was also higher in patients with Crohn's disease.
The research team found that 13 of the studies rated ‘low’ in all domains of a quality assessment, and there was significant statistical heterogeneity.
Dr Abhyankar's team commented, "Patients with inflammatory bowel disease who conceive when their disease is active are more likely to have active disease during pregnancy than those who conceive when in remission."
"All studies used in this analysis had a high risk of bias therefore further studies are required."