How Are Pregnant Patients With Irritable Bowel Syndrome or Functional Dyspepsia Managed Pharmacologically? A...

Irritable Bowel Syndrome (IBS) and Functional Dyspepsia (FD) are gastrointestinal disorders among women of childbearing age, but there is limited safety data on treating these conditions during pregnancy.

We used the TriNetX global health network to identify women aged 18-51 with a recorded pregnancy, dividing them into those with pre-pregnancy IBS or FD diagnoses (IBSFD) and those without (NONE). After excluding alternative causes of their symptoms, we measured the prevalence of IBS/FD treatments during pregnancy-highlighting FDA Pregnancy Class C or lower agents (CLASSC)-and described the characteristics of women receiving these prescriptions. As a sub-analysis, we examined IBS and FD separately, with sensitivity analyses examining patients currently pregnant as of July 2024 and a cohort of patients without competing indications for IBS/FD medications.

The IBSFD group had 10,315 patients, and the NONE group had 1,966,065.45.24% of IBSFD patients were prescribed CLASSC medications and 23.30% in the NONE group (OR 2.72; 95% CI 2.62-2.83). A significant proportion of CLASSC medications were osmotic laxatives, and the odds of receiving most CLASSC IBS/FD medications were higher in the IBSFD group. Patients receiving CLASSC were more likely to be white, have depression or anxiety, and have a history of substance use disorder. Sensitivity analyses confirmed and strengthened these findings.

This study highlights the high prevalence of CLASSC prescriptions during pregnancy and the characteristics of patients receiving them, emphasizing the need for further research on safe treatments for IBS and FD during pregnancy.