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Inflammatory bowel disease and evaluation of pregnancy and fertility

Published on Aug. 25, 2022Total Views: 2720 timesTotal Downloads: 1053 timesDownloadMobile

Author: Rui ZHU Yun-Ling WEN Ying-Lei MIAO

Affiliation: Department of Gastroenterology, First Affiliated Hospital of Kunming Medical University, Kunming 650032, China

Keywords: Inflammatory bowel disease Ulcerative colitis Crohn's disease Pregnancy Fertility

DOI: 10.12173/j.issn.1004-5511.202203037

Reference: Zhu R, Wen YL, Miao YL. Inflammatory bowel disease and evaluation of pregnancy and fertility[J]. Yixue Xinzhi Zazhi, 2022, 32(4): 289-295. DOI: 10.12173/j.issn.1004-5511.202203037.[Article in Chinese]

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Abstract

Inflammatory bowel disease (IBD) is a chronic non-specific inflammatory bowel disease of unknown etiology, mainly including ulcerative colitis (UC) and Crohn's disease (CD). Recently, the inci-dence of IBD has been on the rise in China, and its peak age of onset overlaps with the reproductive age, so safe and effective evaluation of IBD patients' pregnancy and fertility is a challenge for clinicians. This paper summarizes the pregnancy and fertility related problems in IBD patients, in order to provide ref-erence for the treatment of IBD patients of childbearing age.

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References

1.Mak WY, Zhao M, Ng SC, et al. The epidemiology of inflammatory bowel disease: east meets west[J]. J Gastroenterol Hepatol, 2020, 35(3): 380-389. DOI: 10.1111/jgh.14872.

2.Kaplan GG. The global burden of IBD: from 2015 to 2025[J]. Nat Rev Gastroenterol Hepatol, 2015, 12(12): 720-727. DOI: 10.1038/nrgastro.2015.150.

3.Friedman S, Nielsen J, Nøhr EA, et al. Comparison of time to pregnancy in women with and without inflammatory bowel diseases[J]. Clin Gastroenterol Hepatol, 2020, 18(7): 1537-1544.e1. DOI: 10.1016/j.cgh.2019.08.031.

4.Ali MF, He H, Friedel D. Inflammatory bowel disease and pregnancy: fertility, complications and treat-ment[J]. Ann Gastroenterol, 2020, 33(6): 579-590. DOI: 10.20524/aog.2020.0536.

5.Zhao Y, Chen B, He Y, et al. Risk factors associated with impaired ovarian reserve in young women of reproductive age with Crohn's disease[J]. Intest Res, 2020, 18(2): 200-209. DOI: 10.5217/ir.2019.00103.

6.Lee HH, Bae JM, Lee BI, et al. Pregnancy outcomes in women with inflammatory bowel disease: a 10-year nationwide population-based cohort study[J]. Aliment Pharmacol Ther, 2020, 51(9): 861-869. DOI: 10.1111/apt.15654.

7.Druvefors E, Landerholm K, Hammar U, et al. Impaired fertility in women with inflammatory bowel disease: a national cohort study from Sweden[J]. J Crohns Colitis, 2021, 15(3): 383-390. DOI: 10.1093/ecco-jcc/jjaa191.

8.Ananthakrishnan AN, Martin C, Kane S, et al. Paternal disease activity is associated with difficulty in conception among men with inflammatory bowel diseases[J]. Clin Gastroenterol Hepatol, 2019, 17(1): 203-204. DOI: 10.1016/j.cgh.2018.04.001.

9.Shin T, Okada H. Infertility in men with inflammatory bowel disease[J]. World J Gastrointest Pharmacol Ther, 2016, 7(3): 361-369. DOI: 10.4292/wjgpt.v7.i3.361.

10.中华医学会消化病学分会炎症性肠病学组. 炎症性肠病妊娠期管理的专家共识意见[J]. 协和医学杂志, 2019, 10(5): 465-475. [Inflammatory Bowel Disease Group, Digestive Disease Branch, Chinese Medical Association. Expert consensus on the management of inflammatory bowel disease during pregnancy[J]. Medical Journal of Peking Union Medical College Hospital, 2019, 10(5): 465-475.] DOI: 10.3969/j.issn.1674-9081.2019.05.008.

11.van der Woude CJ, Ardizzone S, Bengtson MB, et al. The second European evidenced-based consen-sus on reproduction and pregnancy in inflammatory bowel disease[J]. J Crohns Colitis, 2015, 9(2): 107-124. DOI: 10.1093/ecco-jcc/jju006.

12.刘威, 周伟. 生物制剂时代炎症性肠病的外科治疗[J]. 世界华人消化杂志, 2021, 29(22): 1311-1315. [Liu W, Zhou W. Surgery for inflammatory bowel disease in the era of biologics[J]. World Chinese Journal of Digestol-ogy, 2021, 29(22): 1311-1315.] DOI: 10.11569/wcjd.v28.i22.1311.

13.Rottoli M, Pezzuto P, Fallani G, et al. P199 Ileal pouch-anal anastomosis in women of childbearing age affected by ulcerative colitis: a single-centre study on the risk factors for infertility and outcomes of pregnancy over 17 years[J]. Journal of Crohn's and Colitis, 2022, 16(Supplement_1): i259-i261. DOI: 10.1093/ecco-jcc/jjab232.326.

14.Pachler FR, Toft G, Bisgaard T, et al. Use and success of in vitro fertilisation following restorative proctocolectomy and Ileal pouch-anal anastomosis. A nationwide 17-year cohort study[J]. J Crohns Colitis, 2019, 13(10): 1283-1286.DOI: 10.1093/ecco-jcc/jjz055.

15.Magro F, Gionchetti P, Eliakim R, et al. Third European evidence-based consensus on diagnosis and management of ulcerative colitis. Part 1: definitions, diagnosis, extra-intestinal manifestations, preg-nancy, cancer surveillance, surgery, and Ileo-anal pouch disorders[J]. Journal of Crohn's and Colitis, 2017, 11(6): 649-670. DOI: 10.1093/ecco-jcc/jjx008.

16.Bell SJ, Flanagan EK. Updates in the management of inflammatory bowel disease during pregnancy[J]. Med J Aust, 2019, 210(6): 276-280. DOI: 10.5694/mja2.50062.

17.Selinger CP, Nelson-Piercy C, Fraser A, et al. IBD in pregnancy: recent advances, practical manage-ment[J]. Frontline Gastroenterol, 2020, 12(3): 214-224. DOI: 10.1136/flgastro-2019-101371.

18.Huang VW, Habal FM. From conception to delivery: managing the pregnant inflammatory bowel dis-ease patient[J]. World J Gastroenterol, 2014, 20(13): 3495-3506. DOI: 10.3748/wjg.v20.i13.3495.

19.Odufalu FD, Long M, Lin K, et al. Exposure to corticosteroids in pregnancy is associated with adverse perinatal outcomes among infants of mothers with inflammatory bowel disease: results from the PI-ANO registry[J]. Gut, 2021, gutjnl-2021-325317. DOI: 10.1136/gutjnl-2021-325317.

20.Xiao WL, Liu XY, Liu YS, et al. The relationship between maternal corticosteroid use and orofacial clefts: a meta-analysis[J]. Reprod Toxicol, 2017, 69: 99-105. DOI: 10.1016/j.reprotox.2017.02.006.

21.Zhang Y, Li D, Guo H, et al. Association between thiopurines use and pregnancy outcomes in female patients with inflammatory bowel disease: a meta-analysis[J]. Curr Pharm Des, 2021, 27(19): 2317-2324. DOI: 10.2174/1381612826666200916144249.

22.Akbari M, Shah S, Velayos FS, et al. Systematic review and meta-analysis on the effects of thiopurines on birth outcomes from female and male patients with inflammatory bowel disease[J]. Inflamm Bowel Dis, 2013, 19(1): 15-22. DOI: 10.1002/ibd.22948.

23.Chaparro M, García Donday M, Calviño Suarez C, et al. DOP52 safety of inflammatory bowel disease drugs during pregnancy and breastfeeding: mothers and babies' outcomes (DUMBO registry)[J]. Journal of Crohn's and Colitis, 2021, 15(Supplement_1): S086-S088. DOI: 10.1093/ecco-jcc/jjab073.091.

24.Gonzalez-Suarez B, Sengupta S, Moss AC. Impact of inflammatory bowel disease activity and thiopu-rine therapy on birth weight: a meta-analysis[J]. World J Gastroenterol, 2017, 23(45): 8082-8089. DOI: 10.3748/wjg.v23.i45.8082.

25.Kanis SL, Modderman S, Escher JC, et al. Health outcomes of 1000 children born to mothers with in-flammatory bowel disease in their first 5 years of life[J]. Gut, 2021, 70(7): 1266-1274. DOI: 10.1136/gutjnl-2019-319129.

26.Leroy C, Rigot JM, Leroy M, et al. Immunosuppressive drugs and fertility[J]. Orphanet J Rare Dis, 2015, 10: 136. DOI: 10.1186/s13023-015-0332-8.

27.Laube R, Paramsothy S, Leong RW. Use of medications during pregnancy and breastfeeding for Crohn's disease and ulcerative colitis[J]. Expert Opin Drug Saf, 2021, 20(3): 275-292. DOI: 10.1080/14740338.2021.1873948.

28.Singh S, Murad MH, Fumery M, et al. First- and second-line pharmacotherapies for patients with moderate to severely active ulcerative colitis: an updated network Meta-analysis[J]. Clin Gastroenterol Hepatol, 2020, 18(10): 2179-2191.e6. DOI: 10.1016/j.cgh.2020.01.008.

29.Soh MC, Moretto M. The use of biologics for autoimmune rheumatic diseases in fertility and preg-nancy[J]. Obstet Med, 2020, 13(1): 5-13. DOI: 10.1177/1753495X1984 1799.

30.Grišić AM, Dorn-Rasmussen M, Ungar B, et al. Infliximab clearance decreases in the second and third trimesters of pregnancy in inflammatory bowel disease[J]. United European Gastroenterol J, 2021, 9(1): 91-101. DOI: 10.1177/2050640620964619.

31.Sako M, Yoshimura N, Sonoda A, et al. Safety prediction of infants born to mothers with Crohn's dis-ease treated with biological agents in the late gestation period[J]. J Anus Rectum Colon, 2021, 5(4): 426-432. DOI: 10.23922/jarc.2021-021.

32.Ghalandari N, Dolhain RJ, Hazes JM, et al. Intrauterine exposure to biologics in inflammatory autoimmune dis-eases: a systematic review[J]. Drugs, 2020, 80(16): 1699-1722. DOI: 10.1007/s40265-020-01376-y.

33.中国医药教育协会炎症性肠病专业委员会. 中国炎症性肠病生物制剂治疗专家建议(试行)[J]. 中华消化病与影像杂志(电子版), 2021, 11(6): 244-256. [Inflammatory Bowel Disease Professional Committee of China Medi-cal Education Association. Consensus on biological agents in treating patients with inflammatory bowel disease in China[J]. Chinese Journal of Digestion And Medical Imageology (Electronic Edition), 2021, 11(6): 244-256.] DOI: 10.3877/cma.j.issn.2095-2015. 2021.06.002.

34.Chambers CD, Johnson DL, Xu R, et al. Birth outcomes in women who have taken adalimumab in pregnancy: a prospective cohort study[J]. PLoS One, 2019, 14(10): e0223603. DOI: 10.1371/journal.pone.0223603.

35.Burmester GR, Landewé R, Genovese MC, et al. Adalimumab long-term safety: infections, vaccination response and pregnancy outcomes in patients with rheumatoid arthritis[J]. Ann Rheum Dis, 2017, 76(2): 414-417. DOI: 10.1136/annrheumdis-2016-209322.

36.Moens A, Van Der Woude CJ, Julsgaard M, et al. Pregnancy outcomes in inflammatory bowel disease patients treated with vedolizumab, anti-TNF or conventional therapy: results of the European CON-CEIVE study[J]. Aliment Pharmacol Ther, 2020, 51(1): 129-138. DOI: 10.1111/apt.15539.

37.Mahadevan U, Vermeire S, Lasch K, et al. Vedolizumab exposure in pregnancy: outcomes from clinical studies in inflammatory bowel disease[J]. Aliment Pharmacol Ther, 2017, 45(7): 941-950. DOI: 10.1111/apt.13960.

38.Wang H, Chen F, Hu Y, et al. Adverse pregnancy outcomes following exposure to biologics in women with Crohn's disease: a systematic review and meta-analysis[J]. Front Med (Lausanne), 2021, 8: 753088. DOI: 10.3389/fmed.2021.753088.

39.Geldhof A, Volger S, Lin CB, et al. P538 pregnancy outcomes in women with psoriasis, psoriatic arthri-tis, Crohn's disease and ulcerative colitis treated with ustekinumab[J]. Journal of Crohn's and Colitis, 2020, 14(Supplement_1): S460-S460. DOI: 10.1093/ecco-jcc/jjz203.666.

40.Venturin C, Nancey S, Danion P, et al. Fetal death in utero and miscarriage in a patient with Crohn's disease under therapy with ustekinumab: case-report and review of the literature[J]. BMC Gastroen-terol, 2017, 17(1): 80. DOI: 10.1186/s12876-017-0633-6.

41.Restellini S, Biedermann L, Hruz P, et al. Update on the management of inflammatory bowel disease during pregnancy and breastfeeding[J]. Digestion, 2020, 101 Suppl 1: 27-42. DOI: 10.1159/000502886.

42.Raine T, Bonovas S, Burisch J, et al. ECCO guidelines on therapeutics in ulcerative colitis: medical treatment[J]. Journal of Crohn's and Colitis, 2021, 16(1): 2-17. DOI: 10.1093/ecco-jcc/jjab178.

43.Lasa JS, Olivera PA, Danese S, et al. Efficacy and safety of biologics and small molecule drugs for pa-tients with moderate-to-severe ulcerative colitis: a systematic review and network meta-analysis[J]. Lancet Gastroenterol Hepatol, 2022, 7(2): 161-170. DOI: 10.1016/S2468-1253(21)00377-0.

44.Mahadevan U, Dubinsky MC, Su C, et al. Outcomes of pregnancies with maternal/paternal exposure in the tofacitinib safety databases for ulcerative colitis[J]. Inflamm Bowel Dis, 2018, 24(12): 2494-2500. DOI: 10.1093/ibd/izy160.

45.Gisbert JP, Chaparro M. Safety of new biologics (vedolizumab and ustekinumab) and small molecules (tofacitinib) during pregnancy: a review[J]. Drugs, 2020, 80(11): 1085-1100. DOI: 10.1007/s40265-020-01346-4.

46.Nash P, Kerschbaumer A, Dörner T, et al. Points to consider for the treatment of immune-mediated inflammatory diseases with Janus kinase inhibitors: a consensus statement[J]. Ann Rheum Dis, 2021, 80(1): 71-87. DOI: 10.1136/annrheumdis-2020-218398.

47.Chen XL, Mao JW, Wang YD. Selective granulocyte and monocyte apheresis in inflammatory bowel disease: Its past, present and future[J]. World J Gastrointest Pathophysiol, 2020, 11(3): 43-56.  DOI: 10.4291/wjgp.v11.i3.43.

48.D'ovidio V, Meo D, Gozer M, et al. Ulcerative colitis and granulocyte-monocyte-apheresis: safety and efficacy of maintenance therapy during pregnancy[J]. J Clin Apher, 2015, 30(1): 55-57. DOI: 10.1002/jca.21349.

49.Takahashi H, Sugawara K, Sugimura M, et al. Flare up of ulcerative colitis during pregnancy treated by adsorptive granulocyte and monocyte apheresis: therapeutic outcomes in three pregnant patients[J]. Arch Gynecol Obstet, 2013, 288(2): 341-347. DOI: 10.1007/s00404-013-2748-5.

50.Tan P, Li X, Shen J, et al. Fecal microbiota transplantation for the treatment of inflammatory bowel disease: an update[J]. Front Pharmacol, 2020, 11: 574533. DOI: 10.3389/fphar.2020.574533.

51.Saeedi BJ, Morison DG, Kraft CS, et al. Fecal microbiota transplant for clostridium difficile infection in a pregnant patient[J]. Obstet Gynecol, 2017, 129(3): 507-509. DOI: 10.1097/AOG.0000000000001911.