title: Inflammatory Bowel Disease Increases Risk of Adverse Pregnancy Outcomes: A Meta-Analysis.
abstract: BACKGROUND
  Inflammatory bowel disease may place women at greater risk of adverse pregnancy outcomes.
  
  
  OBJECTIVE
  To examine the association between inflammatory bowel disease and adverse pregnancy outcomes: preterm birth, small for gestational age (SGA) birth weight, congenital anomalies, and stillbirth.
  
  
  METHODS
  We searched PubMed, EMBASE, the Cochrane Database of Systematic Reviews, and ClinicalTrials.gov for studies published from January 1980 through February 2014 and reference lists of relevant studies. We reviewed 1748 citations and identified studies evaluating outcomes of pregnancies complicated by inflammatory bowel disease. Selected studies evaluated one or more of the outcomes of interest, were in English, and gave sufficient details to perform meta-analysis. Three investigators independently reviewed articles for inclusion; discordant decisions were resolved by team review and consensus. Twenty-three studies that included 15,007 women with inflammatory bowel disease (5449 Crohn's, 6559 ulcerative colitis) and 4,614,271 controls met selection criteria. Random-effects analytical methods were used to generate pooled odds ratios.
  
  
  RESULTS
  We found an increased odds of the outcomes studied among women with inflammatory bowel disease compared with non-diseased controls: 1.85 for preterm birth (22 studies; 95 % confidence interval [CI] 1.67-2.05), 1.36 for SGA birth weight (13 studies; 95 % CI 1.16-1.60), 1.57 for stillbirth (10 studies; 95 % CI 1.03-2.38), and 1.29 for congenital anomalies (11 studies; 95 % CI 1.05-1.58). The latter result, however, may be unreliable secondary to publication bias.
  
  
  CONCLUSIONS
  Inflammatory bowel disease may increase the odds of adverse pregnancy outcomes.
authors.affiliation: Department of Gastroenterology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA, 02215, USA, aoibhlinn@hotmail.com.
authors.forename: Aoibhlinn
authors.initials: A
authors.lastname: O'Toole
authors.forename: Ogochukwu
authors.initials: O
authors.lastname: Nwanne
authors.forename: Tracy
authors.initials: T
authors.lastname: Tomlinson
mesh_terms: D001724:Birth Weight; D000013:Congenital Abnormalities / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007236:Infant, Small for Gestational Age; D015212:Inflammatory Bowel Diseases / Q000453:epidemiology*; D011247:Pregnancy; D047928:Premature Birth / Q000453:epidemiology*; D017594:Publication Bias; D012307:Risk Factors; D050497:Stillbirth / Q000453:epidemiology*