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Pregnancy related issues in inflammatory bowel disease:Evidence base and patients' perspective

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Inflammatory bowel disease (IBD) affects women of childbearing age and can influence fertility,pregnancy and decisions regarding breastfeeding.Women with IBD need to consider the possible course of disease during pregnancy,the benefits and risks associated with medications required for disease management during pregnancy and breastfeeding and the effects of mode of delivery on their disease.When indicated,aminosalicylates and thiopurines can be safely used during pregnancy.Infliximab and Adalimumab are considered probably safe during the first two trimesters.During the third trimester the placenta can be crossed and caution should be applied.Methotrexate is associated with severe teratogenicity due to its folate antagonism and is strictly contraindicated.Women with IBD tend to deliver earlier than healthy women,but can have a vaginal delivery in most cases.Caesarean sections are generally recommended for women with active perianal disease or after ileo-anal pouch surgery.While the impact of disease activity and medication has been addressed in several studies,there are minimal studies evaluating patients' perspective on these issues.Women's attitudes may influence their decision to have children and can positively or negatively influence the chance of conceiving,and their beliefs regarding therapies may impact on the course of their disease during pregnancy and/or breastfeeding.This review article outlines the impact of IBD and its treatment on pregnancy,and examines the available data on patients' views on this subject.

PregnancyBreast-feedingNursingInflammatory bowel diseaseCrohn's diseaseUlcerative colitis

Christian P Selinger、Rupert WL Leong、Simon Lal

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Department of Gastroenterology, Salford Royal Hospital, Salford M6 8HD, United Kingdom

Gastroenterology and Liver Services, Sydney Local Health Network, Concord Hospital, NSW 2139 Sydney, Australia

Faculty of Medicine, The University of New South Wales, NSW 2052 Sydney, Australia

2012

10.3748/wjg.v18.i21.2600

世界胃肠病学杂志(英文版)
太原消化病研治中心

世界胃肠病学杂志(英文版)

SCI
影响因子：1.001
ISSN：1007-9327
年,卷(期)：2012.18(21)
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