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Update on Pregnancy in Inflammatory Bowel Disease
1Division of General Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts.
Abstract:
Ongoing clinical and population health research continues to inform evidence-based management of patients with inflammatory bowel disease during pregnancy. Advances in noninvasive tools for disease monitoring highlight the expanding role of intestinal ultra-sound for point-of-care assessments throughout pregnancy. Updates in medical management include recent data demonstrating the association between thiopurines and intrahepatic cholestasis of pregnancy, the role of low-dose aspirin in preventing hypertensive disorders of pregnancy, and guidance related to Janus kinase inhibitor safety. Evolving pharmacologic data inform the safety and increasing use of biosimilars during pregnancy, the emergence of newer targeted therapies such as selective interleukin-23p19 inhibitors, and emerging evidence to support the safety of rotavirus vaccination in infants exposed to biologics in utero. This article summarizes several key updates on diagnostics, treatment, and preventative care strategies aimed at improving maternal and fetal health.
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