NEW YORK, N.Y.—According to new data presented at 2012 DDW, there is no increased risk of birth defects among newborns of women who take certain biologic (infliximab, adalimumab and certolizumab) or immunomodulator (azathioprine and 6-mercaptopurine) therapy to control their inflammatory bowel disease (IBD). These results are from a national registry of 1,100 women from a Crohn’s & Colitis Foundation of America sponsored trial.
"This is very exciting news for women since we know the use of medication during pregnancy garners great concern for both the patient and the physician," said Uma Mahadevan, MD, member of the Crohn’s & Colitis Foundation of America’s Clinical Research Alliance and Associate Professor of Medicine, University of California, Center for Colitis and Crohn’s Disease, San Francisco. “We need to educate women and the physicians that care for them that the biggest risk during pregnancy is a disease flare, not the medication."
The risk of flaring during pregnancy is the same as in the non-pregnant IBD patient: approximately 33 percent per year. Ideally, women should be in remission and on stable maintenance medication prior to attempting conception. Women with IBD have the same rate of fertility as women of the same age without IBD, unless they have had surgery in the pelvis. Women with IBD have higher rates of complications during pregnancy and should be treated as high-risk obstetric patients. Even women with inactive IBD can have an increased risk of miscarriage, preterm birth, small-for-gestational-age infants, and complications of labor and delivery.
“A multi-disciplinary approach involving the gastroenterologist, obstetrician and pediatrician is needed to provide the best care for this complex patient population," said Dr. Mahadevan.
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