Managing inflammatory bowel disease during pregnancy MdpiMedicine inflammatoryboweldisease IBD IBS pregnancy management womenshealth
By Neha MathurAug 7 2023Reviewed by Sophia Coveney In a recent article published in Reproductive Medicine, researchers presented information on scientific evidence-based inflammatory bowel disease management methods during pregnancy.
Dedicated specialized IBD–pregnancy clinics could assist in improving patient knowledge and attitudes toward pregnancy through individualized pre-conception counseling, education, and medication adherence. An observational study demonstrated that compared to fecal calprotectin , gastrointestinal ultrasonography provided better visuals of the terminal ileum and colon in women gestating since 20 weeks with specificity, sensitivity, and negative predictive values of 83%, 74%, and 90%, respectively.
The gut microbiome fluctuates in IBD, and the maternal microbiome also changes due to pregnancy, especially in the third trimester when the maternal gut harbors increased inflammatory changes and reduced gut diversity, which, in turn, impacts the developing neonatal microbiota. In cases of active perianal disease and ileal pouch-anal anastomosis , a C-section must be considered due to raised concerns about adhesions and bowel obstructions, even though it does not influence the delivery mode in patients with CD.
Yet, most women with IBD cease breastfeeding early due to concerns about drug transfer through breast milk. Even the results of studies done in this regard are conflicting. Recently, a study showed that mothers with IBD have reduced IgA levels and lactose in their breast milk, which dampens its beneficial effects.
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