Pregnancy and Crohn's Disease

Fielding, J. F.; Cooke, W. T.

doi:10.1136/bmj.2.5701.76

Cited by 87 publications

(46 citation statements)

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“…While spontaneous abortion rates in patients with quiescent disease at the time of conception disease to age-matched controls found no significant difference in the ability to conceive [4,5], earlier data are similar to those of control groups [12], there is a 60% risk of postoperative spontaneous abortion in those demonstrate reduced fertility [2,6]. Furthermore, one study indicates that colonic as opposed to ileal involve-patients requiring surgical intervention for disease refractory to medical therapy and nonoperative decompression ment leads to greater infertility, 67 versus 26% [7]. Prior studies did not consider disease localization when exam- [13].…”

supporting

confidence: 51%

Inflammatory Bowel Disease and Pregnancy: A Review

Jospe

Peppercorn²

1999

Dig Dis

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Inflammatory bowel disease often occurs during peak reproductive years. Rates of conception, pregnancy outcome and disease course during pregnancy should be discussed prior to attempted conception. The majority of patients whose disease is well controlled prior to pregnancy should expect a fertility rate comparable to the general population, and an uncomplicated pregnancy with a favorable outcome. The disease should continue to be pharmacologically or surgically controlled as necesssary during pregnancy; the majority of drug options available to pregnant patients being without detriment to the fetus. No predictable inheritance pattern has been established and, at this time, there is no ability to screen prenatally.

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supporting

confidence: 51%

Inflammatory Bowel Disease and Pregnancy: A Review

Jospe

Peppercorn²

1999

Dig Dis

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“…By comparison, UC has less of an effect on fertility, unless patients had undergone any IBD related surgery [12,13] . Several other factors associated with active IBD can also contribute to the overall lower rate of conception in IBD including dyspareunia, low libido, and depression [14][15][16] . Dyspareunia (painful sexual congress) often occurs secondary to pelvic surgery, from IBD-associated inflammation, or psychological stress associated with IBD.…”

Section: Fertilitymentioning

confidence: 99%

Pregnancy and inflammatory bowel diseases: Current perspectives, risks and patient management

Hosseini‐Carroll¹,

Mutyala²,

Seth³

et al. 2015

WJGPT

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Manas K made critical revisions of the manuscript; Becker F and Alexander JS contributed equally as senior authors. Conflict-of-interest statement:There are no known conflicts of interest. The authors (Pegah Hosseini-Carroll, Monica Mutyala, Abhishek Seth, Shaheen Nageeb, Demiana Soliman, Moheb Boktor, Ankur Sheth, Jonathon Chapman, James Morris, Paul Jordan, Kenneth Manas, Felix Becker, and J Steven Alexander) have no relevant financial considerations related to this proposal, and the study was not supported by any corporate entity. There is no known intellectual property associated with this report. AbstractInflammatory 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 157November 6, 2015|Volume 6|Issue 4| WJGPT|www.wjgnet.com Hosseini-Carroll P et al . Pregnancy and inflammatory bowel diseases 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. Core tip: Inflammatory bowel diseases (IBD) are chronic inflammatory conditions characterized by relapsing and remitting episodes of intestinal inflammation. IBD is most frequently diagnosed during peak female reproductive years, with 25% of women with IBD conceiving after their diagnosis. While therapies have improved dramatically, IBDs have important effects on pregnancy and present challenges for maintaining optimal outcomes for mothers and their developing fetus/ neonate. Women with IBD and physician...

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“…Reasons for this are likely multifactorial and may be related to fever, pain, diarrhea and malnutrition frequently seen in IBD flares, as well as dyspareunia, decreased libido and depression [10][11][12]. There may also be an immunologic basis involving T-cell dysfunction given young infertile women without IBD but with Th1/Th2 cytokine elevation have improved in vitro fertilization rates using adalimumab, which as a TNF-α inhibitor has been proposed to cause a shift in the Th1/Th2 balance [13].…”

Section: Fertilitymentioning

confidence: 99%

Management of inflammatory bowel disease in pregnancy

Ng¹,

2013

Expert Review of Clinical Immunology

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Pregnancy and Crohn's Disease

Cited by 87 publications

References 1 publication

Inflammatory Bowel Disease and Pregnancy: A Review

Inflammatory Bowel Disease and Pregnancy: A Review

Pregnancy and inflammatory bowel diseases: Current perspectives, risks and patient management

Management of inflammatory bowel disease in pregnancy

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