[Pregnancy outcome in inflammatory bowel diseases].
OBJECTIVE
To assess pregnancy outcome in relation to disease activity and maintenance therapy in patients with inflammatory bowel disease.


METHODS
A postal questionnaire was sent to every woman of child-bearing age followed for inflammatory bowel disease in three referral centers (Rothschild, Saint-Lazare, Saint-Louis). Response rate was 65%.


RESULTS
One hundred and forty-four pregnancies (153 fetuses) in 138 women (122 had Crohn's disease) were reported. Outcome of pregnancy was normal (baby > 2500 g, without malformation) in 115 cases (77%). There were 17 cases of preterm birth (11.5%), 3 cases of hypotrophy, and 14 pregnancy losses (9 miscarriages (6%), 4 therapeutic abortions for major malformation (2.8%)). Percentages of normal pregnancy outcome were not different between patients who continued maintenance therapy and those who stopped: respective percentages were 75 vs 73% in patients receiving mesalamine or olsalazine (n = 30), and 60 vs 75% in patients receiving azathioprine (n = 22).


CONCLUSIONS
In a selected series of women with inflammatory bowel disease, pregnancy outcome is approaching that observed in a normal population, except for an elevated rate of preterm births. There is no need to stop maintenance therapy with 5-aminosalicylates or azathioprine during pregnancy.
Tennenbaum
R
R
Services de Gastroentérologie, Hôpital Rothschild, Paris.
Marteau
P
P
Elefant
E
E
Rambaud
J C
JC
Modigliani
R
R
Gendre
J P
JP
Cosnes
J
J
D000636:Aminosalicylic Acids / Q000009:adverse effects / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects / Q000627:therapeutic use; D001379:Azathioprine / Q000009:adverse effects / Q000627:therapeutic use; D003424:Crohn Disease / Q000188:drug therapy; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy*; D019804:Mesalamine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D011241:Prednisone / Q000009:adverse effects / Q000627:therapeutic use; D011247:Pregnancy; D011248:Pregnancy Complications; D011256:Pregnancy Outcome; D011379:Prognosis; D011795:Surveys and Questionnaires
D000636:Aminosalicylic Acids; D000894:Anti-Inflammatory Agents, Non-Steroidal; D019804:Mesalamine; D001379:Azathioprine; C032587:olsalazine; D011241:Prednisone
Pronostic de la grossesse au cours des maladies inflammatoires intestinales.