The use of biologic therapy in pregnancy: a gastroenterologist's perspective

Curr Opin Rheumatol. 2014 May;26(3):347-53. doi: 10.1097/BOR.0000000000000048.

Abstract

Purpose of review: Inflammatory bowel disease (IBD) often affects women in their peak reproductive years, and therapy is often continued during pregnancy to maintain stable disease activity. Therapeutic options have expanded over the last 2 decades with the advent of new biologic options. It is, therefore, important for the gastroenterologists and other clinicians caring for patients with IBD to understand safety data regarding the treatment options, both biologic and nonbiologic, in pregnant IBD patients.

Recent findings: In general, quality of evidence in this area remains low. However, larger prospective studies are beginning to provide evidence regarding the potential safety of biologics both alone and in conjunction with nonbiologic therapy.

Summary: The majority of treatment options for IBD appears to be of low risk and may often be continued through pregnancy and lactation. Not treating IBD, for example, by discontinuing therapy prior to or with pregnancy, may pose a greater risk to mother and fetus in many cases.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adalimumab
  • Aminosalicylic Acids / adverse effects
  • Aminosalicylic Acids / therapeutic use
  • Antibodies, Monoclonal, Humanized / adverse effects
  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Biological Products / adverse effects
  • Biological Products / therapeutic use
  • Biological Therapy / adverse effects
  • Biological Therapy / methods*
  • Female
  • Glucocorticoids / adverse effects
  • Glucocorticoids / therapeutic use
  • Humans
  • Inflammatory Bowel Diseases / drug therapy*
  • Pregnancy
  • Pregnancy Complications / drug therapy*
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors

Substances

  • Aminosalicylic Acids
  • Antibodies, Monoclonal, Humanized
  • Biological Products
  • Glucocorticoids
  • Tumor Necrosis Factor-alpha
  • Adalimumab