Leung Kristel K, Tandon Parul, Govardhanam Vivek, Maxwell Cynthia, Huang Vivian
Division of Gastroenterology, University of Toronto, Toronto, Ontario, Canada.
Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
Inflamm Bowel Dis. 2021 Mar 15;27(4):550-562. doi: 10.1093/ibd/izaa122.
Patients with inflammatory bowel disease (IBD) may be at increased risk of adverse neonatal outcomes. The aim of this study was to determine pooled incidences and risk factors for these outcomes.
Medline, Embase, and Cochrane Library were searched through May 2019 for studies reporting adverse neonatal outcomes in IBD. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated.
The pooled incidence of preterm birth, low birth weight, congenital anomalies, and infants transferred to the neonatal intensive care unit was 8.6% (95% CI, 7.0%-10.1%), 8.9% (95% CI, 7.3%-10.5%), 2.1% (95% CI, 1.6%-2.6%), and 4.9% (95% CI, 2.9%-6.9), respectively. Compared with healthy controls, patients with IBD were more likely to deliver infants with low birth weight (<2500 grams; OR, 2.78; 95% CI, 1.16-6.66) and infants admitted to the intensive care unit (OR, 3.33; 95% CI, 1.83-6.05). Patients with Crohn's disease had an increased incidence of congenital anomalies (OR, 3.03; 95% CI, 1.43-6.42). Among IBD patients, active disease was associated with increased incidence of preterm birth (OR, 2.06; 95% CI, 1.21-3.51), low birth weight (OR, 2.96; 95% CI, 1.54-5.70), and small for gestational age (OR, 2.62; 95% CI, 1.18-5.83). Antitumor necrosis factor (anti-TNF) use during pregnancy was associated with an increased incidence of neonatal intensive care unit admission (OR, 2.42; 95% CI, 1.31-4.45) and low birth weight (OR, 1.54; 95% CI, 1.01-2.35).
Patients with IBD, particularly with active disease or requiring anti-TNF therapy, may be at increased risk of developing adverse neonatal outcomes.
炎症性肠病（IBD）患者出现不良新生儿结局的风险可能会增加。本研究的目的是确定这些结局的合并发生率及风险因素。
检索截至2019年5月的Medline、Embase和Cochrane图书馆，查找报告IBD患者不良新生儿结局的研究。计算比值比（OR）及95%置信区间（CI）。
早产、低出生体重、先天性异常以及转入新生儿重症监护病房的婴儿的合并发生率分别为8.6%（95%CI，7.0%-10.1%）、8.9%（95%CI，7.3%-10.5%）、2.1%（95%CI，1.6%-2.6%）和4.9%（95%CI，2.9%-6.9%）。与健康对照相比，IBD患者分娩低出生体重婴儿（<2500克；OR，2.78；95%CI，1.16-6.66）以及入住重症监护病房婴儿的可能性更高（OR，3.33；95%CI，1.83-6.05）。克罗恩病患者先天性异常的发生率增加（OR，3.03；95%CI，1.43-6.42）。在IBD患者中，疾病活动与早产（OR，2.06；95%CI，1.21-3.51）、低出生体重（OR，2.96；95%CI，1.54-5.70）以及小于胎龄儿（OR，2.62；95%CI，1.18-5.83）的发生率增加相关。孕期使用抗肿瘤坏死因子（抗TNF）与新生儿重症监护病房入住率（OR，2.42；95%CI，1.31-4.45）及低出生体重（OR，1.54；95%CI，1.01-2.35）的增加相关。
IBD患者，尤其是患有活动性疾病或需要抗TNF治疗的患者，出现不良新生儿结局的风险可能会增加。
