IBD and Motherhood: A Journey through Conception, Pregnancy and Beyond.
Antonio María Caballero MateosMiguel Quesada-CaballeroGuillermo A Cañadas-De la FuenteAlberto Caballero-VázquezFrancisco Contreras-ChovaPublished in: Journal of clinical medicine (2023)
Inflammatory Bowel Disease (IBD) presents distinct challenges during pregnancy due to its influence on maternal health and pregnancy outcomes. This literature review aims to dissect the existing scientific evidence on pregnancy in women with IBD and provide evidence-based recommendations for clinical management. A comprehensive search was conducted across scientific databases, selecting clinical studies, systematic reviews, and other pertinent resources. Numerous studies have underscored an increased risk of complications during pregnancy for women with IBD, including preterm birth, low birth weight, neonates small for gestational age, and congenital malformations. Nevertheless, it's evident that proactive disease management before and throughout pregnancy can mitigate these risks. Continuation of IBD treatment during pregnancy and breastfeeding is deemed safe with agents like thiopurines, anti-TNF, vedolizumab, or ustekinumab. However, there's a call for caution when combining treatments due to the heightened risk of severe infections in the first year of life. For small molecules, their use is advised against in both scenarios. Effective disease management, minimizing disease activity, and interdisciplinary care are pivotal in attending to women with IBD. The emphasis is placed on the continual assessment of maternal and infant outcomes and an expressed need for further research to enhance the understanding of the ties between IBD and adverse pregnancy outcomes.
Keyphrases
- pregnancy outcomes
- preterm birth
- low birth weight
- gestational age
- ulcerative colitis
- birth weight
- pregnant women
- human milk
- preterm infants
- disease activity
- rheumatoid arthritis
- healthcare
- systemic lupus erythematosus
- systematic review
- randomized controlled trial
- case report
- machine learning
- palliative care
- ankylosing spondylitis
- pain management
- quality improvement
- chronic pain
- juvenile idiopathic arthritis
- mental health
- clinical practice
- risk assessment
- body mass index
- human health
- skeletal muscle
- artificial intelligence
- health information
- health insurance
- adipose tissue
- electronic health record
- big data