scholarly journals Surgery for Inflammatory Bowel Disease Has Unclear Impact on Female Fertility: A Cochrane Collaboration Systematic Review

2020 ◽  
Author(s):  
Sangmin Lee ◽  
Megan Crowe ◽  
Cynthia H Seow ◽  
Paulo G Kotze ◽  
Gilaad G Kaplan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Pregnancy Outcomes ◽  
Assisted Reproductive Technologies ◽  
Cochrane Collaboration ◽  
Reproductive Technologies ◽  
Female Fertility ◽  
Inflammatory Bowel ◽  
The Impact

Abstract Background and Aims Surgical treatment of inflammatory bowel disease (IBD) may impair female fertility. We conducted a systematic review to determine the risk of infertility and pregnancy outcomes in women with IBD who underwent surgery. Methods We identified studies evaluating the impact of IBD surgery on infertility and pregnancy outcomes. Risk ratios (RR) and 95% confidence intervals (CIs) were pooled when data were presented using contingency tables. Odds ratios (OR) were pooled when raw numbers were not provided. GRADE was used to evaluate the certainty of evidence. Results Sixteen observational studies were included, comparing women with and without surgery, open and laparoscopic surgery and before and after surgery. All studies were of low quality. The effect of surgery on infertility at 12 months (RR 5.45, 95% CI 0.41 to 72.57) was uncertain. Similarly, the fertility effects of laparoscopic versus open surgery method were unclear (RR 0.70, 95% CI 0.38 to 1.27). The impact of IBD surgery on pregnancy outcomes should be interpreted with caution. Surgery was associated with miscarriage (OR 2.03, 95% CI 1.14 to 3.60), use of assisted reproductive technologies (RR 25.09, 95% CI 1.56 to 403.76) and caesarean section (RR 2.23, 95% CI 1.00 to 4.95), but not with stillbirth (RR 1.96, 95% CI 0.42 to 9.18), preterm birth (RR 1.91, 95% CI 0.67 to 5.48), low birth weight (RR 0.61, 95% CI 0.08 to 4.83) or small for gestational age (RR 2.54, 95% CI 0.80 to 8.01). Conclusion The effect of surgical therapy for IBD on rates of female infertility and pregnancy-related outcomes was uncertain due to poor quality of existing literature.

scholarly journals Impact of the coronavirus infectious disease (COVID-19) pandemic on the provision of inflammatory bowel disease (IBD) antenatal care and outcomes of pregnancies in women with IBD

2021 ◽  
Vol 8 (1) ◽  
pp. e000603
Author(s):  
Christian Philipp Selinger ◽  
Aileen Fraser ◽  
Paul Collins ◽  
Melanie Gunn ◽  
Thean Soon Chew ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Bowel Disease ◽  
Pregnancy Outcomes ◽  
Obstetric Care ◽  
Feeding Rates ◽  
Inflammatory Bowel ◽  
Adverse Pregnancy ◽  
The Impact

BackgroundThe impact of COVID-19 on pregnant inflammatory bowel disease (IBD) patients is currently unknown. Reconfiguration of services during the pandemic may negatively affect medical and obstetric care. We aimed to examine the impacts on IBD antenatal care and pregnancy outcomes.MethodsRetrospective data were recorded in consecutive patients attending for IBD antenatal care including outpatient appointments, infusion unit visits and advice line encounters.ResultsWe included 244 pregnant women with IBD, of which 75 (30.7%) were on biologics in whom the treatment was stopped in 29.3% at a median 28 weeks gestation. In addition, 9% of patients were on corticosteroids and 21.5% continued on thiopurines. The care provided during 460 patient encounters was not affected by the pandemic in 94.1% but 68.2% were performed via telephone (compared with 3% prepandemic practice; p<0.0001). One-hundred-ten women delivered 111 alive babies (mean 38.2 weeks gestation, mean birth weight 3324 g) with 12 (11.0%) giving birth before week 37. Birth occurred by vaginal delivery in 72 (56.4%) and by caesarean section in 48 (43.6%) cases. Thirty-three were elective (12 for IBD indications) and 15 emergency caesarean sections. Breast feeding rates were low (38.6%). Among 244 pregnant women with IBD, 1 suspected COVID-19 infection was recorded.ConclusionIBD antenatal care adjustments during the COVID-19 pandemic have not negatively affected patient care. Despite high levels of immunosuppression, only a single COVID-19 infection occurred. Adverse pregnancy outcomes were infrequent.

scholarly journals The impact of surgical therapies for inflammatory bowel disease on female fertility

2017 ◽  
Author(s):  
Megan Crowe ◽  
Sangmin Lee ◽  
Cynthia H Seow ◽  
Gilaad G Kaplan ◽  
Amy Metcalfe ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Female Fertility ◽  
Inflammatory Bowel ◽  
The Impact

scholarly journals Early Discontinuation of Infliximab in Pregnant Women With Inflammatory Bowel Disease

2019 ◽  
Vol 26 (7) ◽  
pp. 1110-1117 ◽  
Author(s):  
Brindusa Truta ◽  
Ira L Leeds ◽  
Joseph K Canner ◽  
Jonathan E Efron ◽  
Sandy H Fang ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
At Risk ◽  
Disease Activity ◽  
Pregnant Women ◽  
Bowel Disease ◽  
Pregnancy Outcomes ◽  
Early Discontinuation ◽  
Preterm Babies ◽  
Inflammatory Bowel ◽  
The Impact

Abstract Objectives Early discontinuation of infliximab (IFX) in pregnant women with inflammatory bowel disease (IBD) decreases the intrauterine fetal exposure to the drug but may increase the risk of disease flaring leading to poor pregnancy outcomes. In this study, we assessed the impact of early IFX discontinuation on mother’s disease activity and on their at-risk babies. Methods In a retrospective study of the Truven Health Analytics MarketScan database from 2011 to 2015, we compared IBD patients who discontinued IFX more than 90 days (“early IFX”) with those who discontinue IFX 90 days or less (“late IFX) before delivery. We evaluated the risk of flaring, defined by new steroid prescriptions, visits to emergency room and/or hospital admissions, the pregnancy outcomes, and the at-risk babies. Results After IFX discontinuation, the early IFX group (68 deliveries) required significantly more steroid prescriptions than the late IFX group (318 deliveries) to control disease activity (P &lt; 001). There were more preterm babies in the early IFX group (P &lt; 049), but no difference within the 2 groups was noticed in the rate of intrauterine growth retardation, small for gestation, and stillborn babies. Similarly, there was no increase in acute respiratory infections, development delays, and congenital malformations in babies of the mothers from the late IFX vs early IFX groups. Conclusions Steroid-free remission IBD mothers are at risk for disease flares and preterm babies when IFX is discontinued early in pregnancy. Continuation of IFX seems to be safe at least for the first year of life.

Role of Assisted Reproductive Technologies in Inflammatory Bowel Disease: Results from the Piano Registry

2017 ◽  
Vol 152 (5) ◽  
pp. S364
Author(s):  
Priya Kathpalia ◽  
Christopher Martin ◽  
Sumona Saha ◽  
Kim L. Isaacs ◽  
Bincy Abraham ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Assisted Reproductive Technologies ◽  
Reproductive Technologies ◽  
Inflammatory Bowel

scholarly journals The impact of surgical therapies for inflammatory bowel disease on female fertility

2019 ◽  
Author(s):  
Sangmin Lee ◽  
Megan Crowe ◽  
Cynthia H Seow ◽  
Paulo G Kotze ◽  
Gilaad G Kaplan ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Female Fertility ◽  
Inflammatory Bowel ◽  
The Impact
Sign in / Sign up

Export Citation Format

Share Document