title: Pregnancy and breastfeeding in patients with Crohn's disease.
abstract: Crohn's disease commonly affects women of childbearing age. Available data on Crohn's disease and pregnancy show that women with Crohn's disease can expect to conceive successfully, carry to term and deliver a healthy baby. Control of disease activity before conception and during pregnancy is critical, to optimize both maternal and fetal health. Generally speaking, pharmacological therapy for Crohn's disease during pregnancy is similar to pharmacological therapy for nonpregnant patients. Patients maintained in remission by way of pharmacological therapy should continue it throughout their pregnancy. Sulfasalazine, mesalazine and corticosteroids are safe, azathioprine and 6-mercaptopurine are reasonably safe with few discordant data, infliximab seems safe as well, whereas methotrexate is contraindicated during pregnancy. During breastfeeding, mesalazine and prednisone are considered safe, azathioprine/6-mercaptopurine, budesonide and infliximab probably safe and methotrexate is contraindicated.
authors.affiliation: Division of Gastroenterology and Hepatology, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland. christian.mottet@chuv.ch
authors.forename: Christian
authors.initials: C
authors.lastname: Mottet
authors.forename: Pascal
authors.initials: P
authors.lastname: Juillerat
authors.forename: Valérie
authors.initials: V
authors.lastname: Pittet
authors.forename: Jean-Jacques
authors.initials: JJ
authors.lastname: Gonvers
authors.forename: Florian
authors.initials: F
authors.lastname: Froehlich
authors.forename: John-Paul
authors.initials: JP
authors.lastname: Vader
authors.forename: Pierre
authors.initials: P
authors.lastname: Michetti
authors.forename: Christian
authors.initials: C
authors.lastname: Felley
mesh_terms: D000890:Anti-Infective Agents / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001942:Breast Feeding; D003424:Crohn Disease / Q000188:drug therapy; D004359:Drug Therapy, Combination; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use; D019804:Mesalamine; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy; D011256:Pregnancy Outcome; D012449:Safety
chemical_list: D000890:Anti-Infective Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D005938:Glucocorticoids; D007155:Immunologic Factors; D019804:Mesalamine