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Meta-analysis links maternal health, IBD history, and familial factors to increased IBD riskStudy finds link between pregnancy health, family history, and inflammatory bowel disease risk

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Key Takeaway
Note associations between maternal health, IBD history, and familial factors with IBD risk in observational data.

This systematic review and meta-analysis examined associations between parental and perinatal factors and the onset of inflammatory bowel disease (IBD), including Crohn's disease and ulcerative colitis. The analysis included 15 observational studies (9 case-control and 6 cohort studies) comprising 6,507 patients with IBD, where diagnosis was confirmed by endoscopic, radiological, and histopathological findings. No randomized controlled trials were identified in the review.

The analysis found three factors associated with increased risk of overall IBD. Any poor maternal health or disease during pregnancy was associated with a pooled relative risk of 1.78 (95% CI 1.24-2.31). Maternal IBD showed a stronger association with a pooled RR of 4.59 (95% CI 1.68-7.50). Familial history was associated with a pooled RR of 2.87 (95% CI 1.80-3.93). Absolute numbers for these outcomes were not reported.

Safety and tolerability data were not reported in the meta-analysis. The evidence comes exclusively from observational studies, which can show association but not establish causation. The findings suggest potential risk factors but do not provide information about clinical outcomes or absolute risk. These associations may inform discussions about IBD risk but should not be interpreted as causal relationships.

Researchers analyzed 15 previous studies involving 6,507 patients with inflammatory bowel disease (IBD), including Crohn's disease and ulcerative colitis. They wanted to understand whether factors related to parents and pregnancy might be linked to a child's later development of IBD.

The review found three factors were associated with higher IBD risk. When mothers had poor health or illness during pregnancy, their children had about 1.8 times higher risk. When mothers themselves had IBD, their children had about 4.6 times higher risk. Having any family history of IBD was linked to about 2.9 times higher risk.

It's important to understand what this means. These findings come from observational studies that look back at patterns, not controlled experiments. They show association, not proof that these factors cause IBD. Many children exposed to these factors never develop IBD, and many who develop IBD have none of these factors. This research helps identify potential risk patterns for scientists to study further, but cannot be used for individual prediction or prevention advice.

What this means for you:
Observational study links pregnancy health and family history to IBD risk, but cannot show cause or predict individual outcomes.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedMar 2026
View Original Abstract ↓
IntroductionThere is accumulating evidence that certain perinatal and prenatal factors may contribute to the onset of IBD, however evidence on some risk factors is inconsistent. The present study seeks to extend current knowledge on these risk factors and provide a comprehensive overview of which factors are associated with IBD onset and their direction of effect.MethodsA Systematic review and meta-analysis of case-control, cohort studies and randomised controlled trials (RCTs) investigating the association between parental and perinatal factors and onset of IBD was conducted. Studies were included if they reported details on patients with a diagnosis of IBD (including Crohn’s Disease [CD] and/or Ulcerative Colitis [UC]), defined and measured according to endoscopic, radiological, and histopathological findings, confirmed by a gastroenterologist or physician. Computerised bibliographic searches of Ovid MEDLINE, Web of Science, and the Cochrane Library were conducted from 01/01/2002 to the 01/01/2022. Where possible, summaries of the effects of perinatal and prenatal variables for each study were provided by calculating risk estimates using the DerSimonian and Laird random effects model. Levels of heterogeneity were evaluated using the I² statistic. Data were analysed using Stata version 17. Study protocol details are published on the International prospective register of systematic reviews (PROSPERO), registration number: CRD42022290798.ResultsFifteen eligible studies were identified, encompassing 9 case-control and 6 cohort studies, with no RCTs identified. A total of 6,507 patients with IBD were described in these studies (1,819 UC; 3,908 CD; 754 IBD; 4 IBD-unclassified patients). Three predictors of IBD risk were identified. Any poor maternal health or disease in mother during pregnancy (Pooled RR 1.78, 95% CI 1.24-2.31), maternal IBD (Pooled RR 4.59, 95% CI 1.68-7.50), and familial history (Pooled RR 2.87, 95% CI 1.80-3.93), were associated with an increased risk of overall IBD.DiscussionThis systematic review and meta-analysis suggests parental and perinatal factors may have a role in the onset of IBD. These findings highlight the importance of early-life exposures for later IBD development and indicate a requirement for further research in this area.Systematic Review RegistrationPROSPERO, identifier (CRD42022290798).
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