IBD and Pregnancy - HBazan

IBD and Pregnancy - HBazan - TheNaturalHistoryof...

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The Natural History of  Inflammatory Bowel Disease  and Pregnancy Hernan Bazan, MD Team IV Conference 23 April 2004
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Most women with IBD who desire to become pregnant can do  so Conceive successfully, carry to term, and deliver a healthy infant  However, management of IBD during pregnancy is challenging  Misconceptions Unknowns Some women with CD or UC will have difficulty becoming pregnant  or have increased disease symptoms while pregnant  Control of  disease activity  before conception and during  pregnancy is critical to optimize both maternal and fetal health IBD and Pregnancy
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Effect of IBD on Pregnancy
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Effect of IBD on Pregnancy Fertility and Pregnancy: CD Fertility and Pregnancy: UC Effect of CD on Pregnancy Effect of UC on Pregnancy IBD Drug Therapy and Its Effect  on Pregnancy
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IBD and Pregnancy Peak age ranges for pregnancy and IBD  coincide Many women develop CD/UC during reproductive  years Many of the ‘classic’ studies conducted in  1950s: Multiple shortcomings -  Before ‘modern era’ of drug therapy Patients treated with steroids were not always  clearly separated from those who were not Drug therapy was inconsistent No distinctions made on the different anatomical  parts affected Types of complications Early studies on fertility and CD concluded that  fertility is  not  impaired by CD [Crohn et al, Gastroenterology, 1956] However, multiple studies since that time refute  this Fertility has since been shown to be decreased in  CD
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Effect of IBD on Pregnancy Fertility and Pregnancy: CD Fertility and Pregnancy: UC Effect of CD on Pregnancy Effect of UC on Pregnancy IBD Drug Therapy and Its Effect  on Pregnancy
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Fertility and Pregnancy: CD Patients with IBD have fewer children than expected for the  population Fertility has been shown to be decreased in CD [De Dombal et al, BMJ 1972] 40/86 women followed became pregnant (subfertility rate 54% vs. ~8- 10% infertility in healthy couples) After surgery, these women became pregnant at same rate as women  in general population
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IBD and Pregnancy - HBazan - TheNaturalHistoryof...

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