With great interest we have read the study by Ludvigsson et al,1 published in the October issue of Gastroenterology, who performed a population-based study to examine the risks of endoscopy during pregnancy. This nationwide Swedish study showed that exposure to any endoscopy during pregnancy, independent of trimester and indication, was related to preterm birth and children born small for gestational age. However, when restricting data to women without a gastrointestinal disease, risk estimates decreased, and when limiting controls to women with endoscopy <1 year before or after pregnancy, endoscopy was not associated with any adverse pregnancy outcome.