title: Pregnancy and inflammatory bowel diseases: Current perspectives, risks and patient management.
abstract: Inflammatory bowel diseases (IBD) are chronic idiopathic inflammatory conditions characterized by relapsing and remitting episodes of inflammation which can affect several different regions of the gastrointestinal tract, but also shows extra-intestinal manifestations. IBD is most frequently diagnosed during peak female reproductive years, with 25% of women with IBD conceiving after their diagnosis. While IBD therapy has improved dramatically with enhanced surveillance and more abundant and powerful treatment options, IBD disease can have important effects on pregnancy and presents several challenges for maintaining optimal outcomes for mothers with IBD and the developing fetus/neonate. Women with IBD, the medical team treating them (both gastroenterologists and obstetricians/gynecologists) must often make highly complicated choices regarding conception, pregnancy, and post-natal care (particularly breastfeeding) related to their choice of treatment options at different phases of pregnancy as well as post-partum. This current review discusses current concerns and recommendations for pregnancy during IBD and is intended for gastroenterologists, general practitioners and IBD patients intending to become, (or already) pregnant, and their families. We have addressed patterns of IBD inheritance, effects of IBD on fertility and conception (in both men and women), the effects of IBD disease activity on maintenance of pregnancy and outcomes, risks of diagnostic procedures during pregnancy and potential risks and complications associated with different classes of IBD therapeutics. We also have evaluated the clinical experience using "top-down" care with biologics, which is currently the standard care at our institution. Post-partum care and breastfeeding recommendations are also addressed.
authors.affiliation: Pegah Hosseini-Carroll, Abhishek Seth, Moheb Boktor, Ankur Sheth, James Morris, Paul Jordan, Kenneth Manas, Department of Medicine, Section of Gastroenterology and Hepatology, Louisiana State University Health Sciences Center, Shreveport, LA 71130, United States.
authors.forename: Pegah
authors.initials: P
authors.lastname: Hosseini-Carroll
authors.affiliation: Pegah Hosseini-Carroll, Abhishek Seth, Moheb Boktor, Ankur Sheth, James Morris, Paul Jordan, Kenneth Manas, Department of Medicine, Section of Gastroenterology and Hepatology, Louisiana State University Health Sciences Center, Shreveport, LA 71130, United States.
authors.forename: Monica
authors.initials: M
authors.lastname: Mutyala
authors.affiliation: Pegah Hosseini-Carroll, Abhishek Seth, Moheb Boktor, Ankur Sheth, James Morris, Paul Jordan, Kenneth Manas, Department of Medicine, Section of Gastroenterology and Hepatology, Louisiana State University Health Sciences Center, Shreveport, LA 71130, United States.
authors.forename: Abhishek
authors.initials: A
authors.lastname: Seth
authors.affiliation: Pegah Hosseini-Carroll, Abhishek Seth, Moheb Boktor, Ankur Sheth, James Morris, Paul Jordan, Kenneth Manas, Department of Medicine, Section of Gastroenterology and Hepatology, Louisiana State University Health Sciences Center, Shreveport, LA 71130, United States.
authors.forename: Shaheen
authors.initials: S
authors.lastname: Nageeb
authors.affiliation: Pegah Hosseini-Carroll, Abhishek Seth, Moheb Boktor, Ankur Sheth, James Morris, Paul Jordan, Kenneth Manas, Department of Medicine, Section of Gastroenterology and Hepatology, Louisiana State University Health Sciences Center, Shreveport, LA 71130, United States.
authors.forename: Demiana
authors.initials: D
authors.lastname: Soliman
authors.affiliation: Pegah Hosseini-Carroll, Abhishek Seth, Moheb Boktor, Ankur Sheth, James Morris, Paul Jordan, Kenneth Manas, Department of Medicine, Section of Gastroenterology and Hepatology, Louisiana State University Health Sciences Center, Shreveport, LA 71130, United States.
authors.forename: Moheb
authors.initials: M
authors.lastname: Boktor
authors.affiliation: Pegah Hosseini-Carroll, Abhishek Seth, Moheb Boktor, Ankur Sheth, James Morris, Paul Jordan, Kenneth Manas, Department of Medicine, Section of Gastroenterology and Hepatology, Louisiana State University Health Sciences Center, Shreveport, LA 71130, United States.
authors.forename: Ankur
authors.initials: A
authors.lastname: Sheth
authors.affiliation: Pegah Hosseini-Carroll, Abhishek Seth, Moheb Boktor, Ankur Sheth, James Morris, Paul Jordan, Kenneth Manas, Department of Medicine, Section of Gastroenterology and Hepatology, Louisiana State University Health Sciences Center, Shreveport, LA 71130, United States.
authors.forename: Jonathon
authors.initials: J
authors.lastname: Chapman
authors.affiliation: Pegah Hosseini-Carroll, Abhishek Seth, Moheb Boktor, Ankur Sheth, James Morris, Paul Jordan, Kenneth Manas, Department of Medicine, Section of Gastroenterology and Hepatology, Louisiana State University Health Sciences Center, Shreveport, LA 71130, United States.
authors.forename: James
authors.initials: J
authors.lastname: Morris
authors.affiliation: Pegah Hosseini-Carroll, Abhishek Seth, Moheb Boktor, Ankur Sheth, James Morris, Paul Jordan, Kenneth Manas, Department of Medicine, Section of Gastroenterology and Hepatology, Louisiana State University Health Sciences Center, Shreveport, LA 71130, United States.
authors.forename: Paul
authors.initials: P
authors.lastname: Jordan
authors.affiliation: Pegah Hosseini-Carroll, Abhishek Seth, Moheb Boktor, Ankur Sheth, James Morris, Paul Jordan, Kenneth Manas, Department of Medicine, Section of Gastroenterology and Hepatology, Louisiana State University Health Sciences Center, Shreveport, LA 71130, United States.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Manas
authors.affiliation: Pegah Hosseini-Carroll, Abhishek Seth, Moheb Boktor, Ankur Sheth, James Morris, Paul Jordan, Kenneth Manas, Department of Medicine, Section of Gastroenterology and Hepatology, Louisiana State University Health Sciences Center, Shreveport, LA 71130, United States.
authors.forename: Felix
authors.initials: F
authors.lastname: Becker
authors.affiliation: Pegah Hosseini-Carroll, Abhishek Seth, Moheb Boktor, Ankur Sheth, James Morris, Paul Jordan, Kenneth Manas, Department of Medicine, Section of Gastroenterology and Hepatology, Louisiana State University Health Sciences Center, Shreveport, LA 71130, United States.
authors.forename: Jonathan Steven
authors.initials: JS
authors.lastname: Alexander
keywords: Biologics; Breast-feeding; Immunomodulatorsi; Inflammatory bowel diseases; Pregnancy