Drug therapy for inflammatory bowel disease in pregnancy and the puerperium.
Inflammatory bowel disease (IBD) has a peak age of onset in the 3rd decade and a peak prevalent age in the fourth decade in most studies. As a result many patients affected by Crohn's disease and ulcerative colitis are females of reproductive age interested in bearing children. It has been shown that the most important factor in the success of a pregnancy in patients with IBD is the state of disease activity. Therefore, the goal prior to and during pregnancy is to best optimise control of the disease through medical therapy. Unfortunately, many medications utilised to treat IBD are potentially toxic and/or teratogenic, leaving many physicians and patients without a clear answer as to the safest methods of therapy. This review attempts to summarise the medical literature to date, as it pertains to the safety of medical therapy for IBD during pregnancy and the puerperium.
Moffatt
Dana C
DC
University of Manitoba, Department of Internal Medicine, Health Sciences Centre, Winnipeg, Manitoba, Canada. danamoffatt@shaw.ca
Bernstein
Charles N
CN
D000818:Animals; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000494:pharmacology / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000494:pharmacology / Q000627:therapeutic use; D000930:Antidiarrheals / Q000494:pharmacology / Q000627:therapeutic use; D005260:Female; D005395:Fish Oils / Q000494:pharmacology / Q000627:therapeutic use; D005938:Glucocorticoids / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D007155:Immunologic Factors / Q000494:pharmacology / Q000627:therapeutic use; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy*; D019804:Mesalamine / Q000494:pharmacology / Q000627:therapeutic use; D049590:Postpartum Period / Q000187:drug effects*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy*; D019936:Probiotics / Q000494:pharmacology / Q000627:therapeutic use; D012460:Sulfasalazine / Q000494:pharmacology / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D000930:Antidiarrheals; D005395:Fish Oils; D005938:Glucocorticoids; D007155:Immunologic Factors; D012460:Sulfasalazine; D019804:Mesalamine