REALITY OF INFLAMMATORY BOWEL DISEASE IN BRAZILIAN PREGNANT WOMEN (2007/2024)Background: Inflammatory bowel diseases (Crohn’s and Ulcerative colitis) have been increasing alarmingly in Brazil. They affect mainly young people at reproductive age, which is extremely worrying in such a young country. To date, there´s no study that demonstrates how these diseases can affect pregnant women, like drug side effects and how off-springs of Brazilian patients evolve over time.
Objectives: The study aimed to analyze the side effects of medications used by patients with Inflammatory Bowel Disease (IBD) during pregnancy; to assess the impact of disease activity on the course of pregnancy and fetal development and to monitor the development of these children.
Methods: This was a longitudinal retrospective analysis of patients registered over time (2007/2024), regarding the medications used during the conception, side effects, complications during pregnancy and post-delivery. All patients were recruited at the Inflammatory Bowel Disease service at Scope Clinic, located in the Midwest region of Brazil.
Results: Out of the 329 patients, 25 got pregnant (mean age 30.38 years), 48% were in endoscopic activity and 52% were in remission at conception time, and all patients maintained prescribed medication (chimeric and fully human anti-TNF agents, as well as immunosuppressive medications). Disease activity had direct influence on the babies’ weight and on the Apgar score when compared to women in remission, but despite this fact, prematurity was not observed. No undesirable drug effects were observed in both groups (mother and fetus), endorsing their safety over this population. In the postpartum follow-up over a period of two years, no abnormalities were observed.
Conclusion: This study shows the importance of continuously monitoring patients with inflammatory disease and guiding them on drug maintenance and the most appropriate time for conception.
Keywords:
Adverse events; biologic therapy; Crohn’s disease; pregnancy; ulcerative colitis
• A group that has been little studied in Brazil is pregnant women suffering from IBD, and the analysis and dissemination of information about it is extremely important.
• The active disease (IBD) at the time of conception was associated with lower baby weight and lower Apgar scores, but did not lead to prematurity or congenital malformations.
• The most used medications during conception showed no adverse effects in either the mothers or their children, reinforcing the safety of continuous medication during pregnancy.
• The study reinforces that the role of the medical community is not to discourage pregnancy in women with IBD, but rather to guide, clarify doubts and collaborate with patients’ decisions regarding the continuation of medication and the most appropriate time to conceive a new life.
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