Inflammatory bowel disease and pregnancy.

Area of Science:

• Gastroenterology
• Reproductive Medicine
• Obstetrics

Background:

• Inflammatory bowel disease (IBD) frequently affects women of reproductive age.
• Key concerns include IBD's impact on fertility and pregnancy, and vice versa.
• Management of IBD during pregnancy requires careful consideration.

Purpose of the Study:

• To review the existing literature on IBD in pregnant women.
• To discuss the effects of IBD on fertility and pregnancy.
• To outline diagnostic and treatment strategies for IBD during pregnancy.

Main Methods:

• Literature review of studies on IBD, fertility, and pregnancy.
• Analysis of disease effects on conception, abortion rates, and exacerbations.
• Discussion of treatment options and safety of medications during pregnancy.

Main Results:

• Ulcerative colitis does not affect fertility; Crohn's disease may cause temporary subfertility.
• Spontaneous abortion rates are not significantly higher in IBD patients compared to the general population.
• Disease exacerbations occur in 30-50% of pregnancies, similar to non-pregnant IBD patients; active disease at conception increases exacerbation risk.
• Sulfasalazine and steroids are generally considered safe during pregnancy, despite theoretical risks.

Conclusions:

• IBD management during pregnancy should align with standard medical practices.
• Fertility is generally preserved, with temporary subfertility a possibility in Crohn's disease.
• Medications like steroids and sulfasalazine are deemed safe for use in pregnant women with IBD.