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Pregnancy and inflammatory bowel disease
1Department of Medicine, Case Western Reserve University School of Medicine, University Hospitals of Cleveland, Cleveland, Ohio 44106-5066, USA. jeffry.katz@uhhs.com
Current Opinion in Gastroenterology
|February 11, 2005
Summary
Women with inflammatory bowel disease (IBD) face risks in pregnancy. While some therapies are safe, careful discussion before conception is crucial for managing IBD effects on fertility and fetal outcomes.
Area of Science:
- Gastroenterology
- Reproductive Medicine
- Pharmacology
Background:
- Inflammatory bowel disease (IBD) frequently impacts women of reproductive age.
- Concerns exist regarding IBD's effects on fertility, pregnancy, and fetal development.
Purpose of the Study:
- To review recent advances in understanding IBD's impact on fertility and pregnancy outcomes.
- To assess the safety and efficacy of medical therapies for pregnant women with IBD.
Main Methods:
- Critical review of scientific literature published within the last two years.
- Analysis of data on fertility, pregnancy outcomes, and medication safety in IBD patients.
Main Results:
- Significant new data clarify the effects of ulcerative colitis and Crohn disease on fetal outcomes.
- Aminosalicylates and immunomodulators demonstrate overall safety during pregnancy.
- Infliximab exposure appears not to harm the fetus.
Conclusions:
- Crohn disease may increase risks of preterm delivery and low birth weight.
- Ulcerative colitis might be linked to a higher risk of congenital abnormalities.
- 5-aminosalicylate drugs and azathioprine/6-mercaptopurine are considered safe in pregnancy.
- Individualized pre-conception counseling is essential due to potential complications.