O'Toole Aoibhlinn, Nwanne Ogochukwu, Tomlinson Tracy
Department of Gastroenterology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA, 02215, USA,
Dig Dis Sci. 2015 Sep;60(9):2750-61. doi: 10.1007/s10620-015-3677-x. Epub 2015 Jun 13.
Inflammatory bowel disease may place women at greater risk of adverse pregnancy outcomes.
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.
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.
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.
Inflammatory bowel disease may increase the odds of adverse pregnancy outcomes.
炎症性肠病可能使女性出现不良妊娠结局的风险更高。
研究炎症性肠病与不良妊娠结局（早产、小于胎龄儿出生体重、先天性异常和死产）之间的关联。
我们检索了PubMed、EMBASE、Cochrane系统评价数据库和ClinicalTrials.gov，查找1980年1月至2014年2月发表的研究以及相关研究的参考文献列表。我们查阅了1748篇文献，并确定了评估炎症性肠病合并妊娠结局的研究。入选研究评估了一项或多项感兴趣的结局，为英文撰写，且提供了足够细节以进行荟萃分析。三名研究人员独立审查文章以确定是否纳入；存在分歧的决定通过团队审查和达成共识来解决。23项研究纳入了15007例患有炎症性肠病的女性（5449例克罗恩病、6559例溃疡性结肠炎）和4614271例对照，符合入选标准。采用随机效应分析方法生成合并比值比。
我们发现，与未患病的对照相比，患有炎症性肠病的女性出现所研究结局的几率增加：早产为1.85（22项研究；95%置信区间[CI]1.67 - 2.05），小于胎龄儿出生体重为1.36（13项研究；95%CI 1.16 - 1.60），死产为1.57（10项研究；95%CI 1.03 - 2.38），先天性异常为1.29（11项研究；95%CI 1.05 - 1.58）。然而，由于发表偏倚，后一结果可能不可靠。
炎症性肠病可能增加不良妊娠结局的几率。
