Abstract
Inflammatory bowel disease (IBD) is a constellation of devastating chronic inflammatory changes in the bowel, either involving the large or small bowel or part of both. As it is widely diagnosed in the fertile age group, this disorder can present itself, very commonly, during pregnancy and thus a better understanding of the disease can be an important factor to influence the maternal and fetal well-being. Medications are what is considered the first line in the management of this disease to control the symptoms or keep the disease in remission. In addition to this, the drugs used to keep the disease in remission can also cause significant adverse effects on the patient and the new nurturing life preparing itself for the outside world. What the fetus gets from the mother will stay for life with the child. We conducted an electronic literature review search which highlights the significance and impact of sustained remission of IBD and the cautious use of various drugs during pregnancy for that purpose. In addition to the influences already mentioned, It is evident that nutritional deficiencies can also prevail with the advancing disease, something to manage as a side note as well. These deficiencies can have a definite effect on the fetus and may cause developmental malformations. In order to avoid this process, a systemic and joint approach should be curtailed. This can reduce the adverse outcomes associated with this ailment during pregnancy.
Highlights
BackgroundInflammatory Bowel Disease (IBD) is a spectrum of chronic debilitating inflammatory conditions of a relapsing and remitting nature
This article discusses in detail the impact of Inflammatory bowel disease (IBD) on pregnancy and its outcomes
Cyclosporine/Tacrolimus: Immune Suppressants like Cyclosporine/Tacrolimus are medications widely used in the transplant recipients are Food and Drug Administration (FDA) category C for pregnancy and function by T-cell activation inhibition, decrease in the expression of nuclear factor of activated T-cell (NFAT) -regulated cytokines, including interleukin-2 (IL-2), interferon-gamma (IFN-γ), and tumor necrosis factor-alpha (TNF-α) [36]
Summary
Inflammatory Bowel Disease (IBD) is a spectrum of chronic debilitating inflammatory conditions of a relapsing and remitting nature. Cyclosporine/Tacrolimus: Immune Suppressants like Cyclosporine/Tacrolimus are medications widely used in the transplant recipients are FDA category C for pregnancy and function by T-cell activation inhibition, decrease in the expression of nuclear factor of activated T-cell (NFAT) -regulated cytokines, including interleukin-2 (IL-2), interferon-gamma (IFN-γ), and tumor necrosis factor-alpha (TNF-α) [36] These medications lead to the suppression in the immune system by acting on various pathways and are mostly used during drug-resistant IBD. A record of newborn complications, maternal disease activity and complications, medications and developmental milestones in the offspring are noted The impact of these drugs is compared with a control group of IBD patients without immune-suppressive medication or antiTNF treatment. Due to insufficient data on Vedolizumab another humanized IgG1 antibody, it is avoided during pregnancy and lactation [46]
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