Appropriate Preconception Corticosteroid-Free Remission Period in Pregnant Women With Ulcerative Colitis

Area of Science:

• Gastroenterology
• Obstetrics
• Reproductive Medicine

Background:

• Current guidelines recommend at least 3 months of preconception corticosteroid-free remission (CFREM) for women with inflammatory bowel disease.
• Limited data exist on the optimal duration of preconception CFREM.
• This study investigates the impact of varying preconception CFREM periods on maternal disease activity and pregnancy outcomes in ulcerative colitis.

Purpose of the Study:

• To determine the appropriate duration of preconception corticosteroid-free remission (CFREM) in women with ulcerative colitis.
• To assess the effect of preconception CFREM on maternal disease activity during pregnancy and postpartum.
• To evaluate the association between preconception CFREM and adverse pregnancy outcomes.

Main Methods:

• A retrospective study of 141 pregnancies in women with ulcerative colitis.
• Patients were classified into three groups based on preconception CFREM duration: ≥3 months, >0 to <3 months, and non-CFREM.
• Disease activity and adverse pregnancy outcomes were analyzed for each group.

Main Results:

• Active disease during pregnancy was significantly lower in both the ≥3 months and >0 to <3 months CFREM groups compared to the non-CFREM group.
• Active disease postpartum was significantly lower in the ≥3 months CFREM group versus the non-CFREM group.
• A preconception CFREM period of ≥3 months was an independent factor for inhibiting active disease during pregnancy and postpartum.

Conclusions:

• A preconception corticosteroid-free remission (CFREM) period exceeding 3 months appears appropriate for improving maternal and pregnancy outcomes in women with ulcerative colitis.
• The findings support current consensus recommendations for extended preconception remission.