Therapy of inflammatory bowel diseases in pregnancy and lactation

Expert Opin Drug Saf. 2009 Nov;8(6):695-707. doi: 10.1517/14740330903357463.

Abstract

Inflammatory bowel diseases (IBDs) are a group of disorders characterised by chronic or relapsing inflammation within the gastrointestinal tract of variable severity. A chronic medication is often needed and management of fertile women is a crucial point because of the possible adverse effects associated with the administered drugs and the disease itself. The risk of pregnancy-related complications and the disease behaviour during pregnancy depends mainly on disease activity at time of conception. So, it is very important to plan the pregnancy and reach and maintain a clinical remission of the disease before conception. Drugs usually used in IBD treatment include 5- aminosalicylic acid compounds, corticosteroids, azathioprine and 6-mercaptopurine, cyclosporine A, mesalazine, and antibiotics such as metronidazole and ciprofloxacin. Management of IBD in pregnancy at present is not standardised or supported by strong evidence. In this report, we summarise the available data, mainly derived from retrospective and case-control studies, about IBD management in pregnancy, focusing mostly on the safety of drugs during gestation and peripartum.

Publication types

  • Review

MeSH terms

  • Adult
  • Animals
  • Anti-Bacterial Agents / adverse effects
  • Anti-Bacterial Agents / therapeutic use
  • Anti-Inflammatory Agents / adverse effects
  • Anti-Inflammatory Agents / therapeutic use
  • Antidiarrheals / adverse effects
  • Antidiarrheals / therapeutic use
  • Biological Therapy / adverse effects
  • Female
  • Humans
  • Immunosuppressive Agents / adverse effects
  • Immunosuppressive Agents / therapeutic use
  • Inflammatory Bowel Diseases / drug therapy*
  • Lactation / physiology*
  • Postpartum Period
  • Pregnancy
  • Pregnancy Complications / drug therapy
  • Probiotics / adverse effects
  • Probiotics / therapeutic use

Substances

  • Anti-Bacterial Agents
  • Anti-Inflammatory Agents
  • Antidiarrheals
  • Immunosuppressive Agents