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Review
. 2017 Dec 7;23(45):8082-8089.
doi: 10.3748/wjg.v23.i45.8082.

Impact of inflammatory bowel disease activity and thiopurine therapy on birth weight: A meta-analysis

Begoña Gonzalez-Suarez  1 , Shreyashee Sengupta  1 , Alan C Moss  2
Affiliations
Review

Impact of inflammatory bowel disease activity and thiopurine therapy on birth weight: A meta-analysis

Begoña Gonzalez-Suarez et al. World J Gastroenterol. .

Abstract

Aim: To investigate the effect of disease activity or thiopurine use on low birth weight and small for gestational age in women with inflammatory bowel disease (IBD).

Methods: Selection criteria included all relevant articles on the effect of disease activity or thiopurine use on the risk of low birth weight (LBW) or small for gestational age (SGA) among pregnant women with IBD. Sixty-nine abstracts were identified, 35 papers were full text reviewed and, only 14 of them met inclusion criteria. Raw data were extracted to generate the relative risk of LBW or SGA. Quality was assessed using the Newcastle Ottawa Scale.

Results: This meta-analysis is reported according to PRISMA guidelines. Fourteen studies met inclusion criteria, and nine reported raw data suitable for meta-analysis. We found an increased risk ratio of both SGA and LBW in women with active IBD, when compared with women in remission: 1.3 for SGA (4 studies, 95%CI: 1.0-1.6, P = 0.04) and 2.0 for LBW (4 studies, 95%CI: 1.5-2.7, P < 0.0001). Women on thiopurines during pregnancy had a higher risk of LBW (RR 1.4, 95%CI: 1.1-1.9, P = 0.007) compared with non-treated women, but when adjusted for disease activity there was no significant effect on LBW (RR 1.2, 95%CI: 0.6-2.2, P = 0.6). No differences were observed regarding SGA (2 studies; RR 0.9, 95%CI: 0.7-1.2, P = 0.5).

Conclusion: Women with active IBD during pregnancy have a higher risk of LBW and SGA in their neonates. This should be considered in treatment decisions during pregnancy.

Keywords: Disease activity; Inflammatory bowel disease; Low birth weight; Pregnancy; Small for gestational age; Thiopurines.

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Conflict of interest statement

Conflict-of-interest statement: The authors deny any conflict of interest.

Figures

Figure 1
Figure 1
Flow of literature search.
Figure 2
Figure 2
Risk ratio of small for gestational age based on disease activity. SGA: Small for gestational age.
Figure 3
Figure 3
Risk ratio of low birth weight based on disease activity. LBW: Low birth weight.
Figure 4
Figure 4
Risk ratio of small for gestational age based on thiopurine exposure.
Figure 5
Figure 5
Risk ratio of low birth weight based on thiopurine exposure.
See this image and copyright information in PMC

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