title: Fecundity, pregnancy outcomes, and breastfeeding in patients with inflammatory bowel disease: a large cohort survey.
abstract: OBJECTIVE
  The aim was to assess the impact of inflammatory bowel disease (IBD) and its treatment on fertility, pregnancy outcomes, and breastfeeding. IBD is a chronic inflammatory condition that is usually diagnosed in young adulthood. Patients are often concerned about fertility and pregnancy outcomes.
  
  
  METHODS
  A structured questionnaire was posted to 850 adults with IBD followed-up on in a single center.
  
  
  RESULTS
  A total of 503 patients (59%) with a median age of 40 years and equally distributed for gender and type of IBD returned the questionnaire. Overall, 71% of the patients had a total of 659 children, 36% of whom were born after the diagnosis. A total of 132 miscarriages were registered, 46% after the diagnosis of IBD. Most childless patients stated that having no children was a personal decision, and only 6% of them were evaluated and diagnosed with infertility. Pregnancies after diagnosis of IBD had a higher probability of caesarean section and preterm delivery. IBD-related drug therapy was discontinued in 16% of the pregnancies, mainly as a result of medical advice. Babies born after the diagnosis of IBD were less often breastfed.
  
  
  CONCLUSIONS
  The infertility rate among IBD patients seems to be similar to that seen in the general population. However, a large proportion of patients chose to remain childless. Vaginal delivery and breastfeeding are less likely to occur in babies born after the diagnosis. Suitable information for patients to avoid unwarranted concerns about adverse reproductive outcomes, as well as improved obstetrical and perinatal management, still seems to be necessary.
authors.affiliation: Gastroenterology Department, Hospital Universitari Germans Trias i Pujol, IBD Unit, Badalona, Catalonia, Spain. mmanosa.germanstrias@gencat.cat
authors.forename: Míriam
authors.initials: M
authors.lastname: Mañosa
authors.forename: Mercè
authors.initials: M
authors.lastname: Navarro-Llavat
authors.forename: Laura
authors.initials: L
authors.lastname: Marín
authors.forename: Yamile
authors.initials: Y
authors.lastname: Zabana
authors.forename: Eduard
authors.initials: E
authors.lastname: Cabré
authors.forename: Eugeni
authors.initials: E
authors.lastname: Domènech
mesh_terms: D000022:Abortion, Spontaneous / Q000139:chemically induced; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001942:Breast Feeding; D002585:Cesarean Section; D015331:Cohort Studies; D003093:Colitis, Ulcerative / Q000150:complications; D003424:Crohn Disease / Q000150:complications; D004359:Drug Therapy, Combination; D005260:Female; D005298:Fertility / Q000187:drug effects; D005500:Follow-Up Studies; D005765:Gastrointestinal Agents / Q000008:administration & dosage / Q000009:adverse effects; D019538:Health Care Surveys; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects; D007231:Infant, Newborn; D015212:Inflammatory Bowel Diseases / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D011256:Pregnancy Outcome; D012307:Risk Factors; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D005765:Gastrointestinal Agents; D007166:Immunosuppressive Agents