Pregnancy and IBD treatment: This challenging interplay from a patients' perspective
- 1 June 2010
- journal article
- Published by Oxford University Press (OUP) in Journal of Crohn's and Colitis
- Vol. 4 (2), 176-182
- https://doi.org/10.1016/j.crohns.2009.10.001
Abstract
Current data suggest that exacerbations of Inflammatory Bowel Disease (IBD) during pregnancy worsen perinatal outcomes. However, patients' perceptions regarding the interaction between pregnancy and IBD management are unexplored. To (1) obtain pregnancy outcome data from local female IBD patients, and (2) to gain insight into patients' understanding of the interaction between IBD and pregnancy, and how this affects medication-taking behaviour. Female IBD subjects aged 18-50 years were surveyed by questionnaire. This large retrospective study sought patient who reported pregnancy outcomes and examined the relationship between major adverse outcomes, IBD activity and treatment. Subjective data regarding patients' perceptions about IBD management and pregnancy were sought. 219 females were surveyed, 143 completing a questionnaire (68.1%). 342 pregnancies occurred, 298 of which outcome data were available. Overall IBD women reported adverse pregnancy outcome rates comparable to the local population. Major adverse outcomes were more frequent in the subgroup with severe disease during pregnancy (5/14 (35.7%)) than those with inactive disease (14/284 (4.9%)), (OR 6.8 (95% CI 1.7-26.3), p=0.006). Adjusting for disease severity, neither corticosteroid, azathioprine nor 5ASA affected pregnancy outcome. Most female patients (84%) reported (unwarranted) concerns about the effect of IBD medications on pregnancy, free text responses indicating that this was of greater concern than any effect of IBD exacerbation. Unwarranted fear of adverse medication effect on pregnancy is highly prevalent in women with IBD, yet awareness of the harmful effect of IBD exacerbation during pregnancy is poor. This information gap between patients and their gastroenterologists warrants attention.This publication has 39 references indexed in Scilit:
- Inflammatory bowel disease in pregnancyBMJ, 2008
- Review article: use of antitumour necrosis factor therapy in inflammatory bowel disease during pregnancy and conceptionAlimentary Pharmacology & Therapeutics, 2008
- A meta-analysis on the influence of inflammatory bowel disease on pregnancyGut, 2007
- Inflammatory bowel disease and preterm deliveryInternational Journal of Gynecology & Obstetrics, 2005
- Outcome of Pregnancy in Women Receiving Infliximab for the Treatment of Crohn's Disease and Rheumatoid ArthritisThe American Journal of Gastroenterology, 2004
- Perinatal outcomes in inflammatory bowel diseaseThe Journal of Maternal-Fetal & Neonatal Medicine, 2004
- Infliximab treatment and pregnancy outcome in active Crohn's diseaseAmerican Journal Of Gastroenterology, 2001
- Pregnancy outcome for women with Crohn's disease: a follow-up study based on linkage between national registriesAmerican Journal Of Gastroenterology, 1998
- Chronic idiopathic ulcerative colitisDigestive Diseases and Sciences, 1984
- Crohn's disease and pregnancy.Gut, 1984