Pregnancy and the Patient with Inflammatory Bowel Disease: Fertility, Treatment, Delivery, and Complications.
For many women with inflammatory bowel disease (IBD), the illness coincides with their childbearing years. IBD increases the risk of pregnancy complications and adverse pregnancy outcomes. The multidisciplinary care team should emphasize the importance of medication adherence to achieve preconception disease control and maintain corticosteroid-free remission throughout pregnancy. Medication adjustments to reduce fetal exposure may be considered on an individualized basis in quiescent disease; however, any benefits of such adjustments remain theoretic and there is risk of worsening disease activity. Mode of delivery is determined by obstetric indications, except for women with active perianal disease who should consider cesarean delivery.
Division of Gastroenterology, University of California, San Francisco, 1701 Divisadero Street, #120, San Francisco, CA 94115, USA.
Ryan A
RA
McConnell
Division of Gastroenterology, UCSF Center for Colitis and Crohn's Disease, 1701 Divisadero Street, #120, San Francisco, CA 94115, USA. Electronic address: uma.mahadevan@ucsf.edu.
Uma
U
Mahadevan
D000068879:Adalimumab / Q000627:therapeutic use; D000636:Aminosalicylic Acids / Q000627:therapeutic use*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D001688:Biological Products; D001942:Breast Feeding; D019819:Budesonide / Q000627:therapeutic use; D000068582:Certolizumab Pegol / Q000627:therapeutic use; D036861:Delivery, Obstetric / Q000379:methods*; D005260:Female; D005765:Gastrointestinal Agents / Q000627:therapeutic use; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007247:Infertility, Female / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D007248:Infertility, Male / Q000453:epidemiology; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy* / Q000453:epidemiology; D000069285:Infliximab / Q000627:therapeutic use; D008297:Male; D000069442:Natalizumab / Q000627:therapeutic use; D011241:Prednisone / Q000627:therapeutic use; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy*; D011256:Pregnancy Outcome; D018873:Pregnancy Rate
D000636:Aminosalicylic Acids; D000900:Anti-Bacterial Agents; D000911:Antibodies, Monoclonal; D001688:Biological Products; D005765:Gastrointestinal Agents; D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D000069442:Natalizumab; D019819:Budesonide; C529000:golimumab; D000069285:Infliximab; D000068879:Adalimumab; D000068582:Certolizumab Pegol; D011241:Prednisone
Breast feeding; Crohn disease; Drug-related side effects and adverse reactions; Fertility; Inflammatory bowel disease; Obstetric delivery; Pregnancy; Ulcerative colitis