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Methods: A systematic literature search was conducted to identify studies that investigated the pregnancy outcomes among women with IBD on anti-TNF-a therapy. The primary outcome was the overall rate of unfavourable pregnancyrelated outcomes among women with IBD on anti-TNF-a therapy. Secondary outcomes included rates of abortions (spontaneous or elective), preterm delivery, low birth weight, and congenital malformations. Odds ratios (OR) with 95%CI are reported. Studies included met the following criteria: observational or treatment design; had subjects with IBD on anti-TNF-a therapy for at least one trimester; and comparison with appropriately matched controls. Results: Overall, five studies with a total of 1216 participants were eligible for inclusion in the meta-analysis. There was no significant difference in the rates of total unfavourable pregnancy outcomes between pregnant women with IBD who were on anti-TNF-a therapy compared to controls not on antiTNF-a therapy (OR 1.12, 95%CI 0.79 1.59) (Figure 1). Similarly, there were no statistically significant differences in the rates of abortion (OR 1.48, 95%CI 0.93 2.35), preterm birth (OR 1.00, 95%CI 0.62 1.62), low birth weight (OR 1.05, 95%CI 0.62 1.78), or congenital malformation (OR 1.10, 95%CI 0.58 2.09) (Figure 2). Conclusions: The use of anti-TNF-a therapy does not appear to increase the risk of unfavourable pregnancy outcomes among women with IBD, although the optimal timing of therapy through pregnancy and the post-partum period was not assessed in this analysis. This data can help counsel patients around family planning and perinatal management.

journal of crohn's and colitis

DOP041 Intra-uterine ExposuRe to Anti-TNF-alpha therapy (ERA study): Infliximab and adalimumab cord blood levels correlate with maternal levels at birth