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World J Gastroenterol. Apr 7, 2014; 20(13): 3495-3506
Published online Apr 7, 2014. doi: 10.3748/wjg.v20.i13.3495
From conception to delivery: Managing the pregnant inflammatory bowel disease patient
Vivian W Huang, Flavio M Habal
Vivian W Huang, Division of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, Alberta T6G 2X8, Canada
Flavio M Habal, Division of Gastroenterology, Department of Medicine, University Health Network, University of Toronto, Toronto ON M5G 2C4, Canada
Author contributions: Huang VW reviewed the literature and drafted the manuscript; Habal FM reviewed the literature and revised the manuscript; Both authors contributed to conception and design of the review, and approved the final version for publication.
Correspondence to: Flavio M Habal, MD, Division of Gastroenterology, Department of Medicine, University Health Network, University of Toronto, 200 Elizabeth street, Toronto ON M5G 2C4, Canada. flavio.habal@uhn.ca
Telephone: +1-416-3405023 Fax: +1-416-5955251
Received: October 11, 2013
Revised: January 12, 2014
Accepted: February 26, 2014
Published online: April 7, 2014
Processing time: 175 Days and 5.4 Hours
Abstract

Inflammatory bowel disease (IBD) typically affects patients during their adolescent and young adult years. As these are the reproductive years, patients and physicians often have concerns regarding the interaction between IBD, medications and surgery used to treat IBD, and reproduction, pregnancy outcomes, and neonatal outcomes. Studies have shown a lack of knowledge among both patients and physicians regarding reproductive issues in IBD. As the literature is constantly expanding regarding these very issues, with this review, we provide a comprehensive, updated overview of the literature on the management of the IBD patient from conception to delivery, and provide action tips to help guide the clinician in the management of the IBD patient during pregnancy.

Keywords: Inflammatory bowel disease; Pregnancy; Biologics; Neonatal outcomes

Core tip: Inflammatory bowel disease affects people during their reproductive years. Many patients and physicians have concerns about pregnancy in inflammatory bowel disease (IBD), and are unsure about management of IBD during pregnancy. Women with IBD have similar fertility as the general population, with the exception of certain prior surgeries, and actives disease. This review highlights the relative safety of medications used to treat IBD during pregnancy and breastfeeding, and summarizes the updated literature for immunosuppressants and biologics. Good control of disease and clinical remission at the time of conception increases the likelihood of having successful pregnancy outcomes, and quiescent disease during pregnancy.