ORBi: Vermeire Séverine - Management of inflammatory bowel disease in pregnancy

Reference : Management of inflammatory bowel disease in pregnancy


	Document type :	Scientific journals : Article
	Discipline(s) :	Human health sciences : Immunology & infectious disease Human health sciences : Gastroenterology & hepatology
	To cite this reference:	http://hdl.handle.net/2268/123425

Title :	Management of inflammatory bowel disease in pregnancy
Language :	English
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 - ULg > > 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 [Université de Liège - CHU > Gastroentérologie > > >]
Publication date :	2012
Journal title :	Journal of Crohn’s and Colitis [=JCC]
Publisher :	Elsevier
Audience :	International
ISSN :	1873-9946
City :	Amsterdam
Country :	Netherlands
Keywords :	[en] Inflammatory bowel disease ; Crohn's disease ; Ulcerative colitis ; Pregnancy ; Fertility ; Drug treatment
Abstract :	[en] Background. 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. Aim. 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 are the cornerstones of successful pregnancy management in IBD patients.
Target :	Researchers ; Professionals ; Students
Permalink :	http://hdl.handle.net/2268/123425

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