TY  -  JOUR
AU  -  Aratari, Annalisa
AU  -  Zerboni, Giulia
AU  -  De Biasio, Fabiola
AU  -  Viscido, Angelo
AU  -  Papi, Claudio
AU  -  Festa, Stefano
T1  -  What are the challenges in selecting pharmacotherapy
for pregnant women with inflammatory bowel disease?
PY  -  2021
Y1  -  2021-05-01
DO  -  10.1701/3608.35874
JO  -  Recenti Progressi in Medicina
JA  -  Recenti Prog Med
VL  -  112
IS  -  5
SP  -  371
EP  -  377
PB  -  Il Pensiero Scientifico Editore
SN  -  2038-1840
Y2  -  2026/05/01
UR  -  http://dx.doi.org/10.1701/3608.35874
N2  -  Summary. The peak of incidence of inflammatory bowel disease (IBD) overlaps with the peak of reproductive age. Moreover, women affected by IBD are often concerned with the possible negative effects of their disease and medications on pregnancy and birth outcomes. From a physician point of view, managing IBD in pregnancy is challenging. Disease activity is the major cause of poor pregnancy outcomes and, therefore, achieving and maintaining IBD remission for the whole duration of pregnancy is the main therapeutic goal. The challenges in selecting therapy lie in balancing the proven efficacy of each drug with the level of safety uncertainty. Except for methotrexate and thalidomide, for which it exits an absolute contraindication in pregnancy, the evidence actually available suggest that most medications can be safely used during pregnancy if appropriately prescribed. The risks associated with drug withdrawal may be higher than the known risks of the medications themselves on pregnancy outcomes. However, all the decisions should be shared with the patient, all available information should be discussed and any therapeutic strategy must be tailored according to patient’s context, including disease pattern, activity, severity and acceptance of risk.
ER  -