TY - JOUR
T1 - The risk of venous thromboembolism in women with inflammatory bowel disease during pregnancy and the postpartum period
T2 - A systematic review and meta-analysis
AU - Kim, Yeon Hee
AU - Pfaller, Birgit
AU - Marson, Alanna
AU - Yim, Hyeon Woo
AU - Huang, Vivian
AU - Ito, Shinya
AU - Guo, Weimin
N1 - Funding Information:
Yeon Hee Kim was granted by the Sungeui Scholarship of the Catholic University of Korea, Seoul Korea, and the financial support of the Catholic Medical Center Research Foundation made in the program year of 2019.
Publisher Copyright:
© 2019 the Author(s). Published by Wolters Kluwer Health, Inc.
PY - 2019/9/1
Y1 - 2019/9/1
N2 - Pregnancy and inflammatory bowel disease (IBD) are independent risk factors for venous thromboembolism (VTE). Nevertheless, the optimal VTE prevention strategy for women with IBD in pregnancy and postpartum period has not been established yet. We assessed VTE risks during pregnancy and the postpartum period in women with IBD through systematic review and meta-analysis.Systematic searches were conducted in MEDLINE (Ovid), Embase (Ovid), CENTRAL (Ovid), and Web of Science (Tomson Reuters) from the database inception till May 2017 to identify relevant studies reporting the risk of VTE during pregnancy and/or the postpartum period in women with IBD. Random effect meta-analyses were performed to compare VTE-related outcomes between women with IBD and without IBD. Our protocol was registered: CRD 42017060199 in the PROSPERO International prospective register of systematic reviews.In the analysis of 5 studies reviewed, IBD population (n=17,636) had a significantly increased risk of VTE during pregnancy (pooled risk ratio (RR) 2.13, 95% confidence interval (CI) 1.66-2.73) and postpartum (RR 2.61, 95% CI 1.84-3.69), comparing to the non-IBD population (n=11,251,778). According to the location of VTE, the risk of deep vein thrombosis increased significantly by RR of 2.74 (95% CI 1.73-4.36) during pregnancy, whilst risk increase of pulmonary embolism was not statistically significant. In the subgroup analysis, the degree of VTE risk was higher in both periods in the UC group than in the CD group, as compared to that in the non-IBD population (UC group, during pregnancy: RR 2.24, 95% CI 1.6-3.11; postpartum period: RR 2.85, 95% CI 1.79-4.52).Significantly increased risks of VTE during pregnancy were found in the women with IBD, according to the periods and type of IBD, which might support a detailed strategy regarding administration of prophylactic anticoagulants to women with IBD.
AB - Pregnancy and inflammatory bowel disease (IBD) are independent risk factors for venous thromboembolism (VTE). Nevertheless, the optimal VTE prevention strategy for women with IBD in pregnancy and postpartum period has not been established yet. We assessed VTE risks during pregnancy and the postpartum period in women with IBD through systematic review and meta-analysis.Systematic searches were conducted in MEDLINE (Ovid), Embase (Ovid), CENTRAL (Ovid), and Web of Science (Tomson Reuters) from the database inception till May 2017 to identify relevant studies reporting the risk of VTE during pregnancy and/or the postpartum period in women with IBD. Random effect meta-analyses were performed to compare VTE-related outcomes between women with IBD and without IBD. Our protocol was registered: CRD 42017060199 in the PROSPERO International prospective register of systematic reviews.In the analysis of 5 studies reviewed, IBD population (n=17,636) had a significantly increased risk of VTE during pregnancy (pooled risk ratio (RR) 2.13, 95% confidence interval (CI) 1.66-2.73) and postpartum (RR 2.61, 95% CI 1.84-3.69), comparing to the non-IBD population (n=11,251,778). According to the location of VTE, the risk of deep vein thrombosis increased significantly by RR of 2.74 (95% CI 1.73-4.36) during pregnancy, whilst risk increase of pulmonary embolism was not statistically significant. In the subgroup analysis, the degree of VTE risk was higher in both periods in the UC group than in the CD group, as compared to that in the non-IBD population (UC group, during pregnancy: RR 2.24, 95% CI 1.6-3.11; postpartum period: RR 2.85, 95% CI 1.79-4.52).Significantly increased risks of VTE during pregnancy were found in the women with IBD, according to the periods and type of IBD, which might support a detailed strategy regarding administration of prophylactic anticoagulants to women with IBD.
KW - Crohn disease
KW - inflammatory bowel disease
KW - pregnancy
KW - ulcerative colitis
KW - venous thromboembolism
KW - Humans
KW - Risk Factors
KW - Postpartum Period
KW - Pregnancy
KW - Inflammatory Bowel Diseases/complications
KW - Pregnancy Complications/epidemiology
KW - Female
KW - Venous Thromboembolism/etiology
UR - http://www.scopus.com/inward/record.url?scp=85072774387&partnerID=8YFLogxK
U2 - 10.1097/MD.0000000000017309
DO - 10.1097/MD.0000000000017309
M3 - Journal article
C2 - 31568016
AN - SCOPUS:85072774387
SN - 0025-7974
VL - 98
SP - e17309
JO - Medicine (United States)
JF - Medicine (United States)
IS - 38
M1 - e17309
ER -