title: Review article: the management of Crohn's disease and ulcerative colitis during pregnancy and lactation.
abstract: BACKGROUND
  Inflammatory bowel diseases (IBD) commonly affect young patients in the reproductive phase of their lives. The chronic and relapsing nature of IBD and the potential need for medical or surgical interventions raise concerns about family planning issues.
  
  
  OBJECTIVE
  To review the current knowledge on IBD management in pregnant and nursing IBD patients.
  
  
  METHODS
  A PubMed literature search was performed using the search terms 'reproduction' and 'inflammatory bowel disease' and using the headers and main subjects of each section of this article as search terms.
  
  
  RESULTS
  Male and female fertility are not impaired in the majority of IBD patients. In IBD patients with quiescent disease pregnancy outcomes are not impaired in comparison to the general population, however, an increased incidence of pregnancy complications is observed in active IBD patients. As methotrexate (MTX) has been demonstrated to be teratogenic, the use of MTX is contraindicated in patients, who wish to conceive, throughout pregnancy and when nursing. However, normal pregnancies following MTX treatment at conception and later have been reported. Most of the other currently approved IBD medications are not associated with adverse pregnancy outcomes and may be used to maintain quiescent disease or to induce a rapid remission in patients with flares and active disease. Breast-feeding in IBD patients is possible and recommended.
  
  
  CONCLUSIONS
  The overall outcome of pregnancies in IBD patients is favourable and not different to healthy controls, thus patients with IBD should not be discouraged from having children.
authors.affiliation: Department of Medicine I - Gastroenterology, Hepatology, Oncology and Nutrition, Agaplesion Markus Hospital, Goethe University, Frankfurt, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Schulze
authors.forename: P
authors.initials: P
authors.lastname: Esters
authors.forename: A
authors.initials: A
authors.lastname: Dignass
mesh_terms: D000305:Adrenal Cortex Hormones / Q000494:pharmacology / Q000627:therapeutic use; D001688:Biological Products / Q000494:pharmacology / Q000627:therapeutic use; D001942:Breast Feeding; D003093:Colitis, Ulcerative / Q000175:diagnosis / Q000188:drug therapy*; D003424:Crohn Disease / Q000175:diagnosis / Q000188:drug therapy*; D019468:Disease Management; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007774:Lactation / Q000187:drug effects; D008297:Male; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000188:drug therapy*; D011256:Pregnancy Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D001688:Biological Products