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Managing Crohn's Disease During Pregnancy
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Managing Crohn's Disease During Pregnancy

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Highlights:
  • Women with Crohn’s disease can have a safe pregnancy if the disease is under control
  • Women need to consult obstetricians that can guide them with the safest option available.
  • Medications are given which are safe during pregnancy and breastfeeding

Women with Crohn's disease need to make sure they take adequate steps to consult a doctor to have a safe pregnancy. As long as the disease is under proper control, women will not experience complications during their pregnancy.

What is Crohn's Disease?
Crohn's disease is a condition of the digestive tract, known as inflammatory bowel disease (IBD). This is a chronic disorder mainly characterized by the inflammation of the gastrointestinal (GI) tract.

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Managing Crohn's Disease During Pregnancy

Crohn's disease may also affect other parts of the body, such as joints, skin, liver, and eyes. About one in a million Americans have inflammatory bowel disease. It generally results in abdominal pain and diarrhea.

Why is Crohn's Disease a Concern for Women?

Both men and women are also equally susceptible to inflammatory bowel disease.

The disease is particularly problematic in women as the symptoms generally start between 20 and 40 years of age, the child-bearing years of women.
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Women must know when it is safe to get pregnant. Women who have their disease in check at the time contraception have a lower risk of complications during their pregnancy.

What are the Options for Women with Crohn's Disease?

Around twenty years ago, most women diagnosed with the disease would have been recommended not to have children.

Now many women can have a safe pregnancy and delivery as long as they go into pregnancy without active disease.

The obstetrician should be well educated and should advise patients for the safest pregnancy and post-pregnancy options.

Medications need to be taken to keep IBD in proper check before and during pregnancy. Although there are limited data, most IBD drugs appear safe during pregnancy and breastfeeding.

Every woman needs to decide on her own what is best for herself and the baby, says Dr. Jacqueline Wolf, an expert on IBD and pregnancy.

Dr. Wolf advises women to remain in IBD medication during pregnancy. Only drug exceptions are methotrexate and tofacitinib, which should not be used during pregnancy.

Jenna Adler of Salem, MA whose disease remained in remission during her pregnancy said that the doctors assured her that her medications were safe. The doctors only have initial concerns about the biologic drug infliximab, which may affect the baby's immune system.

Adam Cheifetz, MD, director of the Center of Inflammatory Bowel Disease and BIDMC, said that they don't recommend live rotavirus for infants of mothers on biologic therapies.

Although the medication can be transferred through the placenta during the third trimester, no adverse effects have been observed on the fetus.

In a few women, the medication is timed so that the last dose of the medicine is given weeks before childbirth. However, in most women, the medication is continued safely during the pregnancy.

In summary, women with Crohn's disease need to consult and talk to their doctors about what is their safest option during pregnancy.



Source: Medindia

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