title: Assessment of Physicians' Perceived Risk of Inflammatory Bowel Disease Medications in Pregnant Patients.
abstract: Many female patients with inflammatory bowel disease (IBD) are affected during their reproductive years, and the benefits of continuing medical therapy to maintain remission during pregnancy generally outweigh the risks of therapy cessation. Knowledge of the current guidelines is important to maximize maternal and fetal outcomes.
  
  
  METHODS
  A total of 116 practitioners (family medicine [FM], n = 35; internal medicine [IM], n = 22; obstetrics/gynecol-ogy [Ob/Gyn], n=23; gastroenterology [GI], n = 36) responded to a survey. Respondents were asked about the US Food and Drug Administration classifications of common IBD drugs, the need for caution when administering live vaccines to neonates exposed to biologic agents in utero, and 2 scenarios of patients with IBD who wanted to become pregnant.
  
  
  RESULTS
  Compared with GI physicians, FM + IM physicians were less likely to correctly identify infliximab (Remicade, Janssen Biotech) as a pregnancy category B drug (67% vs 30%; P=.0005). Among all respondents, 38% were unaware of the need to delay administration of live vaccines to infants exposed to anti-tumor necrosis factor agents in utero. GI specialists were more likely to advise patients to continue their IBD regimen (biologic agents and thiopurines) during pregnancy than non-GI (IM, FM, and Ob/Gyn) physicians (biologic agents: 86% vs 46%; P<.0001 and thiopurines: 69% vs 15%; P<.0001). Overall, 78% of non-GI physicians said that they would change their practice based on the survey.
  
  
  CONCLUSIONS
  Practitioners caring for pregnant patients may lack awareness regarding the safety and management of IBD drugs during pregnancy. Bringing awareness through education may increase the number of physicians following best practice guidelines.
authors.affiliation: Mr Rhodes and Mr Smith are medical students at the University of Oklahoma College of Medicine and the University of Oklahoma Health Sciences Center in Oklahoma City, Oklahoma. Mr Adams is a graduate research assistant and Dr Stoner is a professor and the chair of the Department of Biostatistics and Epidemiology at the University of Oklahoma Health Sciences Center. Dr Ali is an assistant professor of medicine in the Section of Digestive Diseases and Nutrition at the University of Oklahoma Health Sciences Center.
authors.forename: Robert
authors.initials: R
authors.lastname: Rhodes
authors.affiliation: Mr Rhodes and Mr Smith are medical students at the University of Oklahoma College of Medicine and the University of Oklahoma Health Sciences Center in Oklahoma City, Oklahoma. Mr Adams is a graduate research assistant and Dr Stoner is a professor and the chair of the Department of Biostatistics and Epidemiology at the University of Oklahoma Health Sciences Center. Dr Ali is an assistant professor of medicine in the Section of Digestive Diseases and Nutrition at the University of Oklahoma Health Sciences Center.
authors.forename: Zachary
authors.initials: Z
authors.lastname: Smith
authors.affiliation: Mr Rhodes and Mr Smith are medical students at the University of Oklahoma College of Medicine and the University of Oklahoma Health Sciences Center in Oklahoma City, Oklahoma. Mr Adams is a graduate research assistant and Dr Stoner is a professor and the chair of the Department of Biostatistics and Epidemiology at the University of Oklahoma Health Sciences Center. Dr Ali is an assistant professor of medicine in the Section of Digestive Diseases and Nutrition at the University of Oklahoma Health Sciences Center.
authors.forename: Jaymes
authors.initials: J
authors.lastname: Adams
authors.affiliation: Mr Rhodes and Mr Smith are medical students at the University of Oklahoma College of Medicine and the University of Oklahoma Health Sciences Center in Oklahoma City, Oklahoma. Mr Adams is a graduate research assistant and Dr Stoner is a professor and the chair of the Department of Biostatistics and Epidemiology at the University of Oklahoma Health Sciences Center. Dr Ali is an assistant professor of medicine in the Section of Digestive Diseases and Nutrition at the University of Oklahoma Health Sciences Center.
authors.forename: Julie
authors.initials: J
authors.lastname: Stoner
authors.affiliation: Mr Rhodes and Mr Smith are medical students at the University of Oklahoma College of Medicine and the University of Oklahoma Health Sciences Center in Oklahoma City, Oklahoma. Mr Adams is a graduate research assistant and Dr Stoner is a professor and the chair of the Department of Biostatistics and Epidemiology at the University of Oklahoma Health Sciences Center. Dr Ali is an assistant professor of medicine in the Section of Digestive Diseases and Nutrition at the University of Oklahoma Health Sciences Center.
authors.forename: Tauseef
authors.initials: T
authors.lastname: Ali
keywords: Inflammatory bowel disease; biologies; pregnancy; thiopurines