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©2014 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jul 21, 2014; 20(27): 8790-8795
Published online Jul 21, 2014. doi: 10.3748/wjg.v20.i27.8790
Published online Jul 21, 2014. doi: 10.3748/wjg.v20.i27.8790
Treatment of Crohn’s disease in pregnant women: Drug and multidisciplinary approaches
Didia Bismara Cury, Center of Inflammatory Bowel Disease, Federal University of São Paulo, Sao Paulo, SP 040023-062, Brazil
Didia Bismara Cury, Center of Inflammatory Bowel Disease, Clinica Scope, Campo Grande, MS 79002212, Brazil
Didia Bismara Cury, Beth Israel Medical Center of Harvard Medical School, Sao Paulo, CEP 04023-062, Brazil
Alan C Moss, Beth Israel Deaconess Medical Center, Division of Gastroenterology, Boston, MA 02215, United States
Alan C Moss, Harvard Medical School, Boston, MA 02215, United States
Author contributions: Cury DB and Moss AC contributed to the manuscript.
Correspondence to: Didia Bismara Cury, Director, Center of Inflammatory Bowel Disease, Clinica Scope, Campo Grande, MS 79002212, Brazil. didia_cury@uol.com.br
Telephone: +55-673-3256040 Fax: +55-673-3256040
Received: November 19, 2013
Revised: February 11, 2014
Accepted: April 5, 2014
Published online: July 21, 2014
Revised: February 11, 2014
Accepted: April 5, 2014
Published online: July 21, 2014
Core Tip
Core tip: Patients should be encouraged to postpone conception until their Crohn’s disease (CD) is in remission. Monitoring of nutritional status remains important in patients with small bowel CD; folic acid, vitamin D and vitamin B12 may all need to be supplemented. Most drug treatments are safe in pregnancy, based on observational data, including 5-aminosalicylic acid, thiopurines, anti-tumor necrosis factor, and anti-integrins. Methotrexate should be avoided due to its teratogenicity. Cesarean section is only indicated from a CD perspective in women with active perianal disease at the time of delivery; all others can have a normal vaginal delivery.