Pregnancy in Patients with Inflammatory Bowel Diseases—A Literature Review

Abstract

In recent years, we have faced an increasing incidence of inflammatory bowel disease (IBD), especially among young people, affecting them during their reproductive years. The paucity of data and reduced knowledge regarding the evolution of the disease during pregnancy and the adverse effects of the therapy on the mother and infant increase voluntary childlessness in this group of patients. Depending on the type of IBD, severity and surgical or medical management, this can negatively affect the pregnancy. C-sections and the risk of low-birth-weight babies are higher in women with IBD, independent of active/inactive disease, while preterm birth, stillbirth and miscarriage are associated with disease activity. In the last period, medicinal therapy has evolved, and new molecules have been developed for better control of the lesions, but the effect on pregnancy and breastfeeding is still controversial. We conducted this review by studying the literature and recent research in order to have a better image of the practical management of IBD during pregnancy.

IBD and Motherhood: A Journey through Conception, Pregnancy and Beyond

“…Secondly, most mothers with IBD have normal outcomes during pregnancy. However, in mothers with CD, there is a higher risk of premature birth, low birth weight, or being small for gestational age [156,157]. Another study found the same outcomes but only in children of mothers undergoing treatment with steroids [158].…”

Childlessness in Patients with Inflammatory Bowel Disease – Data from the Prospective Multi-center Swiss IBD Cohort Study

“…Infertility in men with IBD has been even less extensively studied than in their female counterparts [14]. Only very few investigations have addressed male fertility.…”

“…The reasons accountable for VC are multiple, including fear of disease relapse, IBD inheritance, inability or reluctancy to care for the child, additional stress the birth of a child might accompany, or drug interactions during pregnancy [1,12,13]. Voluntary childlessness has been also previously associated with lower educational levels [14]. In summary, the issue of 'infertility' is rather complex, implicates various aspects and represents a nebulous term.…”

Kakvoća prehrane trudnica i žena koje planiraju trudnoću oboljelih od upalnih bolesti crijeva

“…Aktivna faza bolesti povezuje se s negativnim utjecajem na plodnost uzrokujući anemiju i lokalne upale koje zahvaćaju reproduktivne organe, dok aktivni IBD u trudnoći povećava rizik od spontanog pobačaja, prijevremenog poroda, rođenja djece smanjene porodne mase za gestacijsku dob (engl. small for gestational age, SGA), stoga je ključno kontrolirati aktivnost bolesti prije i tijekom trudnoće kako bi se izbjegli navedeni negativni ishodi (Grigorescu i sur., 2023). Kontinuirano liječenje od presudne je važnosti za postizanje i održavanje remisije, stoga je ključno provoditi propisanu terapiju i prilikom planiranja te tijekom trudnoće, kao i tijekom dojenja u svrhu sprečavanja pogoršanja stanja, pojavu simptoma i aktivne faze bolesti.…”