Pregnant women with inflammatory bowel disease (IBD) are more likely to undergo delivery by Caesarean section and face added maternal and neonatal risks, according to a meta-analysis published in Alimentary Pharmacology & Therapeutics.
In a search of Medline, Embase and the Cochrane library through May 2019, 53 eligible studies (7,917 IBD pregnancies and 3,253 healthy control pregnancies) were identified.
The data revealed that caesarean delivery was more common in patients with IBD compared to healthy controls (odds ratio [OR] 1.79; 95% CI 1.16-2.77). This was significant for ulcerative colitis (OR 1.80; 95% CI 1.21-2.90) but not Crohn’s disease (OR 1.48; 95% CI 0.94-2.34).
The analysis also demonstrated increased risks for gestational diabetes (OR 2.96; 95% CI 1.47-5.98) and preterm prelabour membrane rupture in women with IBD. Placental-related disorders, such as pre-eclampsia, placental abruption, and placenta previa, did not appear to be increased in women with IBD. The risk of early pregnancy loss was not significantly increased (OR 1.63; 95% CI 0.49-5.43). However, gestational diabetes occurred more commonly in IBD (OR 2.96; 95% CI 1.47-5.98).
Anti-tumour necrosis factor (anti-TNF) 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).