New research discoveries on endoscopy during pregnancy

According to earlier recommendations, women ought to avoid endoscopy during pregnancy. New analyzes by researchers from the Karolinska Institute and Columbia University could question these recommendations.

In a collaborative study between the Karolinska Institutet and Columbia University, New York, US, researchers have examined the outcome in more than 3000 pregnancies where the women underwent endoscopy during pregnancy. Leader of these studies has been Professor Jonas F Ludvigsson of Department of Medical Epidemiology and Biostatistics at KI.

Until now, endoscopy has been discouraged during pregnancy for few that it may be detrimental to the pregnancy and the fetes. Earlier studies have however been based on less then a few hundred women, often with severe underlying gastrointestinal disease that may have had a larger impact on pregnancy outcome than the endoscopy. Endoscopy is an umbrella term for upper endoscopy (”gastroscopy”), lower endoscopy (colonoscopy) or endoscopic retrograde cholangiopancreatographies.

Compared to pregnancies of women with no endoscopy during pregnancy, women with endoscopy were at increased risk of a number of adverse pregnancy outcome. However, through the use of different comparison groups the researchers were able to disentangle the effect of the endoscopy per se, and the underlying disease.

When restricting the analysis to women with no severe gastrointestinal disease, the difference in pregnancy outcome between women with and without endoscopy during pregnancy was minimal, and when comparing births within the same mother, for which only 1 birth had been exposed to endoscopy (and the other birth not), the researchers found no association between endoscopy and gestational age or birth weight. Congenital malformation was not linked to endoscopy in any analysis.

Publication

Outcomes of Pregnancies for Women Undergoing Endoscopy While They Were Pregnant—a Nationwide Cohort Study

Jonas F. Ludvigsson, Benjamin Lebwohl, Anders Ekbom, Ravi Kiran, Peter HR. Green, Jonas Höijer, Olof Stephansson

NCBI, published online 20 October 2016. doi: 10.1053/j.gastro.2016.10.016