title: Importance of appropriate pharmaceutical management in pregnant women with ulcerative colitis.
abstract: BACKGROUND
  Ulcerative colitis (UC) often occurs in women of childbearing age. Compared to Western countries, however, few studies have investigated the impact of UC on the progress of pregnancy in Asian populations.
  
  
  METHODS
  We retrospectively examined 91 pregnancies in 64 patients with UC experienced at our hospital and related institutions from 1991 to 2011, focusing on the relationship between the progression of UC during pregnancy, progress of the pregnancy itself, and the treatment of UC.
  
  
  RESULTS
  In 80 of 91 pregnancies the patient had already been diagnosed with UC at the time she became pregnant, of whom 31 (38.8%) experienced exacerbation during pregnancy. Regarding severity, moderate or severe active-stage disease during pregnancy was seen in 13.7% of those who had been in remission at the onset of pregnancy versus 58.6% of those who had been in the active stage at onset (OR 8.9: 95%CI 3.0~26.4; P<0.01). The incidence of miscarriage or abortion was 9.8% in pregnancies in which UC was in remission at onset versus 31% in those in which it was in the active stage at onset (OR 4.1: 95%CI 1.2~13.9; P=0.02). Among patients, 62.5% were receiving pharmaceutical treatment at onset of pregnancy. Exacerbation during pregnancy occurred in 26.5% of the group who continued to receive the same treatment during pregnancy versus 56.3% of those with a dose decrease or discontinuation after onset (OR 3.6: 95%CI 1.0~12.4; P=0.04).
  
  
  CONCLUSIONS
  UC patients wishing to conceive should do so when in remission and continue appropriate pharmaceutical treatment during pregnancy.
authors.affiliation: Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Ujihara
authors.forename: Takafumi
authors.initials: T
authors.lastname: Ando
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Ishiguro
authors.forename: Osamu
authors.initials: O
authors.lastname: Maeda
authors.forename: Osamu
authors.initials: O
authors.lastname: Watanabe
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Hirayama
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Morise
authors.forename: Keiko
authors.initials: K
authors.lastname: Maeda
authors.forename: Masanobu
authors.initials: M
authors.lastname: Matsushita
authors.forename: Ryoji
authors.initials: R
authors.lastname: Miyahara
authors.forename: Naoki
authors.initials: N
authors.lastname: Ohmiya
authors.forename: Yuji
authors.initials: Y
authors.lastname: Nishio
authors.forename: Takeo
authors.initials: T
authors.lastname: Yamaguchi
authors.forename: Jun-Ichi
authors.initials: J
authors.lastname: Haruta
authors.forename: Kenji
authors.initials: K
authors.lastname: Ina
authors.forename: Hidemi
authors.initials: H
authors.lastname: Goto
mesh_terms: D000293:Adolescent; D000328:Adult; D003093:Colitis, Ulcerative / Q000150:complications / Q000188:drug therapy*; D005260:Female; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy*; D055815:Young Adult
chemical_list: D005765:Gastrointestinal Agents