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Inflammatory bowel disease and pregnancy
1Department of Medicine, Lenox Hill Hospital, New York, New York, USA.
Gastroenterology Clinics of North America
|April 18, 1998
Summary
Pregnancy outcomes for women with inflammatory bowel disease (IBD) are generally good, especially with medication. Active Crohn's disease can affect fertility and pregnancy, but safe drug therapies improve outcomes.
Area of Science:
- Gastroenterology
- Obstetrics & Gynecology
- Genetics
Background:
- Limited prospective studies exist on inflammatory bowel disease (IBD) and pregnancy.
- Evidence suggests active Crohn's disease impacts fertility.
- Heredity influences IBD type and location.
Purpose of the Study:
- To synthesize current evidence on IBD and pregnancy outcomes.
- To evaluate the impact of disease activity and drug therapy on pregnancy.
- To provide guidance on management during pregnancy.
Main Methods:
- Review of existing literature and evidence.
- Analysis of factors influencing IBD course during pregnancy.
- Assessment of fetal outcomes and maternal health.
Main Results:
- Fertility is reduced in active Crohn's disease.
- Fetal outcomes are comparable to the general population unless IBD is active.
- Disease activity before pregnancy influences its course.
- Medications (sulfasalazine, 5ASA, corticosteroids, immunosuppressives) are generally safe and beneficial.
- Episiotomy is contraindicated with perirectal complications; Cesarean section may be indicated for colonic involvement.
Conclusions:
- Active IBD, particularly Crohn's disease, negatively affects fertility and pregnancy outcomes.
- Effective drug therapy is crucial for favorable outcomes, outweighing risks of medication.
- Management strategies should consider disease activity and potential complications like perirectal issues or colonic involvement.