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. 2002 Jan;78(915):23–26. doi: 10.1136/pmj.78.915.23

Inflammatory bowel disease in pregnancy

E Alstead 1
PMCID: PMC1742232  PMID: 11796867

Abstract

Concerns about sexual health, fertility, and pregnancy are common in patients with inflammatory bowel disease (IBD). Fertility is usually normal, although may be decreased in women with active Crohn's disease. Women with active IBD (especially Crohn's disease) are at risk of having small and premature babies. In some patients with IBD it may be desirable to continue drug treatment during pregnancy in order to control disease activity. Early engagement in discussion of these issues is important and it should be possible for most patients with IBD to have a normal outcome of pregnancy.

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Selected References

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  1. Alstead E. M., Ritchie J. K., Lennard-Jones J. E., Farthing M. J., Clark M. L. Safety of azathioprine in pregnancy in inflammatory bowel disease. Gastroenterology. 1990 Aug;99(2):443–446. doi: 10.1016/0016-5085(90)91027-4. [DOI] [PubMed] [Google Scholar]
  2. Baird D. D., Narendranathan M., Sandler R. S. Increased risk of preterm birth for women with inflammatory bowel disease. Gastroenterology. 1990 Oct;99(4):987–994. doi: 10.1016/0016-5085(90)90617-a. [DOI] [PubMed] [Google Scholar]
  3. Berkovitch M., Pastuszak A., Gazarian M., Lewis M., Koren G. Safety of the new quinolones in pregnancy. Obstet Gynecol. 1994 Oct;84(4):535–538. [PubMed] [Google Scholar]
  4. Bermas B. L., Hill J. A. Effects of immunosuppressive drugs during pregnancy. Arthritis Rheum. 1995 Dec;38(12):1722–1732. doi: 10.1002/art.1780381203. [DOI] [PubMed] [Google Scholar]
  5. Burakoff R., Opper F. Pregnancy and nursing. Gastroenterol Clin North Am. 1995 Sep;24(3):689–698. [PubMed] [Google Scholar]
  6. Burnham W. R., Lennard-Jones J. E., Brooke B. N. Sexual problems among married ileostomists. Survey conducted by The Ileostomy Association of Great Britain and Ireland. Gut. 1977 Aug;18(8):673–677. doi: 10.1136/gut.18.8.673. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Cappell M. S., Colon V. J., Sidhom O. A. A study at 10 medical centers of the safety and efficacy of 48 flexible sigmoidoscopies and 8 colonoscopies during pregnancy with follow-up of fetal outcome and with comparison to control groups. Dig Dis Sci. 1996 Dec;41(12):2353–2361. doi: 10.1007/BF02100127. [DOI] [PubMed] [Google Scholar]
  8. Colombel J. F., Brabant G., Gubler M. C., Locquet A., Comes M. C., Dehennault M., Delcroix M. Renal insufficiency in infant: side-effect of prenatal exposure to mesalazine? Lancet. 1994 Aug 27;344(8922):620–621. doi: 10.1016/s0140-6736(94)92009-5. [DOI] [PubMed] [Google Scholar]
  9. Connell W., Miller A. Treating inflammatory bowel disease during pregnancy: risks and safety of drug therapy. Drug Saf. 1999 Oct;21(4):311–323. doi: 10.2165/00002018-199921040-00006. [DOI] [PubMed] [Google Scholar]
  10. Connell W., Miller A. Treating inflammatory bowel disease during pregnancy: risks and safety of drug therapy. Drug Saf. 1999 Oct;21(4):311–323. doi: 10.2165/00002018-199921040-00006. [DOI] [PubMed] [Google Scholar]
  11. Czeizel A. E., Tóth M., Rockenbauer M. Population-based case control study of folic acid supplementation during pregnancy. Teratology. 1996 Jun;53(6):345–351. doi: 10.1002/(SICI)1096-9926(199606)53:6<345::AID-TERA5>3.0.CO;2-Z. [DOI] [PubMed] [Google Scholar]
  12. Diav-Citrin O., Park Y. H., Veerasuntharam G., Polachek H., Bologa M., Pastuszak A., Koren G. The safety of mesalamine in human pregnancy: a prospective controlled cohort study. Gastroenterology. 1998 Jan;114(1):23–28. doi: 10.1016/s0016-5085(98)70628-6. [DOI] [PubMed] [Google Scholar]
  13. Donnenfeld A. E., Pastuszak A., Noah J. S., Schick B., Rose N. C., Koren G. Methotrexate exposure prior to and during pregnancy. Teratology. 1994 Feb;49(2):79–81. doi: 10.1002/tera.1420490202. [DOI] [PubMed] [Google Scholar]
  14. Fonager K., Sørensen H. T., Olsen J., Dahlerup J. F., Rasmussen S. N. Pregnancy outcome for women with Crohn's disease: a follow-up study based on linkage between national registries. Am J Gastroenterol. 1998 Dec;93(12):2426–2430. doi: 10.1111/j.1572-0241.1998.00698.x. [DOI] [PubMed] [Google Scholar]
  15. Gillibrand P. N. Systemic lupus erythematosus in pregnancy treated with azathioprine. Proc R Soc Med. 1966 Sep;59(9):834–834. [PMC free article] [PubMed] [Google Scholar]
  16. Hernández-Díaz S., Werler M. M., Walker A. M., Mitchell A. A. Folic acid antagonists during pregnancy and the risk of birth defects. N Engl J Med. 2000 Nov 30;343(22):1608–1614. doi: 10.1056/NEJM200011303432204. [DOI] [PubMed] [Google Scholar]
  17. Hudson M., Flett G., Sinclair T. S., Brunt P. W., Templeton A., Mowat N. A. Fertility and pregnancy in inflammatory bowel disease. Int J Gynaecol Obstet. 1997 Aug;58(2):229–237. doi: 10.1016/s0020-7292(97)00088-x. [DOI] [PubMed] [Google Scholar]
  18. Irvine E. J., Feagan B., Rochon J., Archambault A., Fedorak R. N., Groll A., Kinnear D., Saibil F., McDonald J. W. Quality of life: a valid and reliable measure of therapeutic efficacy in the treatment of inflammatory bowel disease. Canadian Crohn's Relapse Prevention Trial Study Group. Gastroenterology. 1994 Feb;106(2):287–296. doi: 10.1016/0016-5085(94)90585-1. [DOI] [PubMed] [Google Scholar]
  19. Keighley M. R., Grobler S., Bain I. An audit of restorative proctocolectomy. Gut. 1993 May;34(5):680–684. doi: 10.1136/gut.34.5.680. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Khosla R., Willoughby C. P., Jewell D. P. Crohn's disease and pregnancy. Gut. 1984 Jan;25(1):52–56. doi: 10.1136/gut.25.1.52. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Korelitz B. I. Inflammatory bowel disease and pregnancy. Gastroenterol Clin North Am. 1998 Mar;27(1):213–224. doi: 10.1016/s0889-8553(05)70354-x. [DOI] [PubMed] [Google Scholar]
  22. Korelitz B. I. Inflammatory bowel disease and pregnancy. Gastroenterol Clin North Am. 1998 Mar;27(1):213–224. doi: 10.1016/s0889-8553(05)70354-x. [DOI] [PubMed] [Google Scholar]
  23. Kornfeld D., Cnattingius S., Ekbom A. Pregnancy outcomes in women with inflammatory bowel disease--a population-based cohort study. Am J Obstet Gynecol. 1997 Oct;177(4):942–946. doi: 10.1016/s0002-9378(97)70298-9. [DOI] [PubMed] [Google Scholar]
  24. Kornfeld D., Cnattingius S., Ekbom A. Pregnancy outcomes in women with inflammatory bowel disease--a population-based cohort study. Am J Obstet Gynecol. 1997 Oct;177(4):942–946. doi: 10.1016/s0002-9378(97)70298-9. [DOI] [PubMed] [Google Scholar]
  25. Larzilliere I., Beau P. Maladies inflammatoires chroniques intestinales et grossesse. Etude cas-témoins. Gastroenterol Clin Biol. 1998 Dec;22(12):1056–1060. [PubMed] [Google Scholar]
  26. Lask B., Jenkins J., Nabarro L., Booth I. Psychosocial sequelae of stoma surgery for inflammatory bowel disease in childhood. Gut. 1987 Oct;28(10):1257–1260. doi: 10.1136/gut.28.10.1257. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Mayberry J. F., Weterman I. T. European survey of fertility and pregnancy in women with Crohn's disease: a case control study by European collaborative group. Gut. 1986 Jul;27(7):821–825. doi: 10.1136/gut.27.7.821. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Mayberry J. F., Weterman I. T. European survey of fertility and pregnancy in women with Crohn's disease: a case control study by European collaborative group. Gut. 1986 Jul;27(7):821–825. doi: 10.1136/gut.27.7.821. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Miller J. P. Inflammatory bowel disease in pregnancy: a review. J R Soc Med. 1986 Apr;79(4):221–225. doi: 10.1177/014107688607900410. [DOI] [PMC free article] [PubMed] [Google Scholar]
  30. Mogadam M., Dobbins W. O., 3rd, Korelitz B. I., Ahmed S. W. Pregnancy in inflammatory bowel disease: effect of sulfasalazine and corticosteroids on fetal outcome. Gastroenterology. 1981 Jan;80(1):72–76. [PubMed] [Google Scholar]
  31. Moody G. A., Mayberry J. F. Perceived sexual dysfunction amongst patients with inflammatory bowel disease. Digestion. 1993;54(4):256–260. doi: 10.1159/000201046. [DOI] [PubMed] [Google Scholar]
  32. Moody G. A., Probert C., Jayanthi V., Mayberry J. F. The effects of chronic ill health and treatment with sulphasalazine on fertility amongst men and women with inflammatory bowel disease in Leicestershire. Int J Colorectal Dis. 1997;12(4):220–224. doi: 10.1007/s003840050093. [DOI] [PubMed] [Google Scholar]
  33. Moody G., Probert C. S., Srivastava E. M., Rhodes J., Mayberry J. F. Sexual dysfunction amongst women with Crohn's disease: a hidden problem. Digestion. 1992;52(3-4):179–183. doi: 10.1159/000200951. [DOI] [PubMed] [Google Scholar]
  34. Narendranathan M., Sandler R. S., Suchindran C. M., Savitz D. A. Male infertility in inflammatory bowel disease. J Clin Gastroenterol. 1989 Aug;11(4):403–406. doi: 10.1097/00004836-198908000-00011. [DOI] [PubMed] [Google Scholar]
  35. Peeters M., Nevens H., Baert F., Hiele M., de Meyer A. M., Vlietinck R., Rutgeerts P. Familial aggregation in Crohn's disease: increased age-adjusted risk and concordance in clinical characteristics. Gastroenterology. 1996 Sep;111(3):597–603. doi: 10.1053/gast.1996.v111.pm8780562. [DOI] [PubMed] [Google Scholar]
  36. Penn I., Makowski E., Droegemueller W., Halgrimson C. G., Starzl T. E. Parenthood in renal homograft recipients. JAMA. 1971 Jun 14;216(11):1755–1761. [PMC free article] [PubMed] [Google Scholar]
  37. Piper J. M., Mitchel E. F., Ray W. A. Prenatal use of metronidazole and birth defects: no association. Obstet Gynecol. 1993 Sep;82(3):348–352. [PubMed] [Google Scholar]
  38. Radomski J. S., Ahlswede B. A., Jarrell B. E., Mannion J., Cater J., Moritz M. J., Armenti V. T. Outcomes of 500 pregnancies in 335 female kidney, liver, and heart transplant recipients. Transplant Proc. 1995 Feb;27(1):1089–1090. [PubMed] [Google Scholar]
  39. Sagar P. M., Lewis W., Holdsworth P. J., Johnston D., Mitchell C., MacFie J. Quality of life after restorative proctocolectomy with a pelvic ileal reservoir compares favorably with that of patients with medically treated colitis. Dis Colon Rectum. 1993 Jun;36(6):584–592. doi: 10.1007/BF02049866. [DOI] [PubMed] [Google Scholar]
  40. Subhani J. M., Hamiliton M. I. Review article: The management of inflammatory bowel disease during pregnancy. Aliment Pharmacol Ther. 1998 Nov;12(11):1039–1053. doi: 10.1046/j.1365-2036.1998.00420.x. [DOI] [PubMed] [Google Scholar]
  41. Subhani J. M., Hamiliton M. I. Review article: The management of inflammatory bowel disease during pregnancy. Aliment Pharmacol Ther. 1998 Nov;12(11):1039–1053. doi: 10.1046/j.1365-2036.1998.00420.x. [DOI] [PubMed] [Google Scholar]
  42. Teahon K., Pearson M., Levi A. J., Bjarnason I. Elemental diet in the management of Crohn's disease during pregnancy. Gut. 1991 Sep;32(9):1079–1081. doi: 10.1136/gut.32.9.1079. [DOI] [PMC free article] [PubMed] [Google Scholar]
  43. Willoughby C. P., Truelove S. C. Ulcerative colitis and pregnancy. Gut. 1980 Jun;21(6):469–474. doi: 10.1136/gut.21.6.469. [DOI] [PMC free article] [PubMed] [Google Scholar]

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