Meta‐analysis: the impact of disease activity at conception on disease activity during pregnancy in patients with inflammatory bowel disease. Issue 5 (15th July 2013)

• Record Type: Journal Article
• Authors: Abhyankar, A.; Ham, M.; Moss, A. C.
• Is Part Of: Alimentary pharmacology & therapeutics. Volume 38:Issue 5(2013)
• Page Start: 460
• Page End: 466
• Publication Date: 2013-07-15
• Subjects: Digestive organs -- Diseases -- Treatment -- Periodicals; Digestive organs -- Effect of drugs on -- Periodicals; Gastrointestinal system -- Diseases -- Treatment -- Periodicals; Gastrointestinal system -- Effect of drugs on -- Periodicals; 615.73
• DOI: 10.1111/apt.12417
• Languages: English
• ISSNs: 0269-2813

Abstract

<abstract abstract-type="main" id="apt12417-abs-0001"> <title>Summary</title> <sec id="apt12417-sec-0001" sec-type="section"> <title>Background</title> <p>The rate of exacerbation of inflammatory bowel disease (IBD) during pregnancy varies in the published literature.</p> </sec> <sec id="apt12417-sec-0002" sec-type="section"> <title>Aim</title> <p>We sought to perform a systematic review and meta‐analysis of the effects of disease activity at conception on disease course during pregnancy in women with IBD.</p> </sec> <sec id="apt12417-sec-0003" sec-type="section"> <title>Methods</title> <p>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.</p> </sec> <sec id="apt12417-sec-0004" sec-type="section"> <title>Results</title> <p>Fourteen studies were eligible for inclusion; ten studies contained patients with UC (<italic>N</italic> = 1130), and six studies contained patients with CD (<italic>N</italic> = 590). In patients with UC there was a significantly higher risk ratio of active disease during pregnancy in patients who commenced pregnancy with active disease (55%), when compared with those in remission at conception (36%) (RR 2.0, 95% CI: 1.5–3, <italic>P</italic> < 0.001). This risk was also higher in patients with CD (RR 2.0, 95% CI: 1.2–3.4, <italic>P</italic> = 0.006). Thirteen of the studies rated 'low' in all domains of a quality assessment, and there was significant statistical heterogeneity.</p> </sec> <sec id="apt12417-sec-0005" sec-type="section"> <title>Conclusions</title> <p>Patients with IBD 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.</p> </sec> </abstract>