CLINICAL REVIEWSNoninvasive Methods For Assessing Inflammatory Bowel Disease Activity in Pregnancy A Systematic ReviewTandon, Parul DO*; Leung, Kristel MD†; Yusuf, Arif MD*; Huang, Vivian W. MSc, MD, FRCPC*Author Information *Division of Gastroenterology, University of Toronto, Toronto †Department of Medicine, The Ottawa Hospital, Ottawa, ON, Canada P.T. and K.L.: contributed equally. The authors declare that they have nothing to disclose. Address correspondence to: Vivian W. Huang, MSc, MD, FRCPC, Division of Gastroenterology, University of Toronto, Preconception and Pregnancy in IBD Clinical Research Program, Mount Sinai Hospital, Sinai Health System, Suite 441—600 University Avenue, Toronto, ON, Canada M5G 1X5 (e-mail: email@example.com). Journal of Clinical Gastroenterology: September 2019 - Volume 53 - Issue 8 - p 574-581 doi: 10.1097/MCG.0000000000001244 Buy SDC Metrics Abstract Active inflammatory bowel disease (IBD) may increase the risk of adverse outcomes during pregnancy. Our aim was to systematically review the role of noninvasive fecal tests, such as fecal calprotectin (FCP) and lactoferrin (FL), and laboratory tests including C-reactive protein (CRP), hemoglobin, and albumin in the assessment of IBD during pregnancy. A systematic search of electronic databases was performed through October 2018 for studies assessing the utility of fecal and laboratory tests in predicting IBD activity in pregnant patients. Active disease was defined based on routinely used clinical criteria such as the Harvey-Bradshaw Index or Mayo score for ulcerative colitis. Noninvasive test levels were stratified by the presence of active disease and by gestational period (preconception, first trimester, second trimester, and third trimester). Thirteen studies were included. Both FCP and FL levels were significantly higher in pregnant patients with IBD compared with those without IBD. FCP levels were also significantly higher in patients with active disease compared with those with the inactive disease during all gestational periods. Furthermore, 3 studies demonstrated no consistent correlation with serum CRP and active IBD during pregnancy. Similarly, serum albumin and hemoglobin levels did not correlate with disease activity in pregnant patients with IBD. Given the lack of high-quality evidence, only FCP appears to correlate with IBD activity in all gestational periods of pregnancy. The utility of the other noninvasive tests such as serum CRP, hemoglobin, and albumin remains to be determined in this population. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.