Article (Scientific journals)
Management of inflammatory bowel disease in pregnancy.
Vermeire, Séverine; Carbonnel, Franck; Coulie, Pierre et al.
2012In Journal of Crohn's and Colitis, 6 (8), p. 811-23
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Keywords :
Colitis, Ulcerative/complications/drug therapy/therapy; Crohn Disease/complications/drug therapy/therapy; Female; Fertility/drug effects; Humans; Immunosuppressive Agents/therapeutic use; Inflammatory Bowel Diseases/complications/drug therapy/therapy; Lactation/drug effects; Male; Pregnancy; Pregnancy Complications/drug therapy/therapy; Pregnancy Outcome
Abstract :
[en] BACKGROUND AND AIMS: Inflammatory bowel disease (IBD) is a chronic disease affecting mainly young people in their reproductive years. IBD therefore has a major impact on patients' family planning decisions. Management of IBD in pregnancy requires a challenging balance between optimal disease control and drug safety considerations. This article aims to provide a framework for clinical decision making in IBD based on review of the literature on pregnancy-related topics. METHODS: Medline searches with search terms 'IBD', 'Crohn's disease' or 'ulcerative colitis' in combination with keywords for the topics fertility, pregnancy, congenital abnormalities and drugs names of drugs used for treatment of IBD. RESULTS: IBD patients have normal fertility, except for women after ileal pouch-anal anastomosis (IPAA) and men under sulfasalazine treatment. Achieving and maintaining disease remission is a key factor for successful pregnancy outcomes in this population, as active disease at conception carries an increased risk of preterm delivery and low birth weight. Clinicians should discuss the need for drug therapy to maintain remission with their patients in order to ensure therapy compliance. Most IBD drugs are compatible with pregnancy, except for methotrexate and thalidomide. If possible, anti-TNF therapy should be stopped by the end of the second trimester and the choice of delivery route should be discussed with the patient. CONCLUSIONS: Disease control prior to conception and throughout pregnancy is the cornerstone of successful pregnancy management in IBD patients.
Disciplines :
Gastroenterology & hepatology
Immunology & infectious disease
Author, co-author :
Vermeire, Séverine;  Katholieke Universiteit Leuven - KUL > UZ Gasthuisberg > Gastroenterology
Carbonnel, Franck;  CHU Jean Minjoz - Besançon > Gastroentérologie et nutrition
Coulie, Pierre;  Université Catholique de Louvain - UCL > de Duve Institute > Physiology and Immunology
Geenen, Vincent ;  Université de Liège - ULiège > Centre d'immunologie
Hazes, Johanna M.W.
Masson, Pierre;  Université Catholique de Louvain - UCL > de Duve Institut
de Keyser, Filip;  Ghent University > Rheumatology
LOUIS, Edouard  ;  Centre Hospitalier Universitaire de Liège - CHU > Gastro-Entérologie-Hépatologie
Language :
English
Title :
Management of inflammatory bowel disease in pregnancy.
Publication date :
2012
Journal title :
Journal of Crohn's and Colitis
ISSN :
1873-9946
eISSN :
1876-4479
Publisher :
Elsevier, Amsterdam, Netherlands
Volume :
6
Issue :
8
Pages :
811-23
Peer reviewed :
Peer Reviewed verified by ORBi
Commentary :
Copyright (c) 2012 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved.
Available on ORBi :
since 24 May 2012

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