[IBD and pregnancy: From conception to birth]

Gynecol Obstet Fertil Senol. 2020 Jun;48(6):514-519. doi: 10.1016/j.gofs.2020.02.013. Epub 2020 Mar 4.
[Article in French]

Abstract

Inflammatory Bowel Diseases (IBD) are chronic conditions affecting young people in their reproductive age. Patient misinformation can be responsible for a self-imposed infertility as well as a suboptimal observance during pregnancy. The aim of this work was to review the influence of IBD and pregnancy on one another at each gestational stage and according to current literature. IBD activity is a major influential factor. In case of a well-controlled IBD, fertility won't be affected and pregnancy will take place without increase risk of complications. With the exception of thalidomide and methotrexate, most of treatments used in IBD are compatible with pregnancy and breastfeeding. Each flare should be optimally managed. Vaginal delivery is a safe option except for patients with active anoperineal lesions. Cesarean section should be systematically discuss in patient with ileal pouch-anal anastomosis.

Keywords: Crohn disease; Fertility; Fertilité; Grossesse; Maladie de Crohn; Pregnancy; Rectocolite hémorragique; Ulcerative colitis.

Publication types

  • Review

MeSH terms

  • Cesarean Section
  • Colitis, Ulcerative / complications
  • Colitis, Ulcerative / drug therapy
  • Colitis, Ulcerative / surgery
  • Crohn Disease / complications
  • Crohn Disease / drug therapy
  • Crohn Disease / surgery
  • Delivery, Obstetric
  • Female
  • Fertilization
  • Fetus / drug effects
  • Gestational Age
  • Humans
  • Infant, Newborn
  • Infertility
  • Inflammatory Bowel Diseases / complications*
  • Inflammatory Bowel Diseases / drug therapy
  • Inflammatory Bowel Diseases / surgery
  • Male
  • Methotrexate / adverse effects
  • Pregnancy
  • Pregnancy Complications / epidemiology
  • Pregnancy Complications / therapy*
  • Pregnancy Outcome*
  • Thalidomide / adverse effects

Substances

  • Thalidomide
  • Methotrexate