Mottet Christian, Juillerat Pascal, Pittet Valérie, Gonvers Jean-Jacques, Froehlich Florian, Vader John-Paul, Michetti Pierre, Felley Christian
Division of Gastroenterology and Hepatology, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland.
Digestion. 2007;76(2):149-60. doi: 10.1159/000111030. Epub 2008 Feb 7.
Crohn's disease commonly affects women of childbearing age. Available data on Crohn's disease and pregnancy show that women with Crohn's disease can expect to conceive successfully, carry to term and deliver a healthy baby. Control of disease activity before conception and during pregnancy is critical, to optimize both maternal and fetal health. Generally speaking, pharmacological therapy for Crohn's disease during pregnancy is similar to pharmacological therapy for nonpregnant patients. Patients maintained in remission by way of pharmacological therapy should continue it throughout their pregnancy. Sulfasalazine, mesalazine and corticosteroids are safe, azathioprine and 6-mercaptopurine are reasonably safe with few discordant data, infliximab seems safe as well, whereas methotrexate is contraindicated during pregnancy. During breastfeeding, mesalazine and prednisone are considered safe, azathioprine/6-mercaptopurine, budesonide and infliximab probably safe and methotrexate is contraindicated.
克罗恩病常见于育龄女性。现有关于克罗恩病与妊娠的数据表明，患有克罗恩病的女性有望成功受孕、足月分娩并诞下健康婴儿。在受孕前及孕期控制疾病活动对于优化母婴健康至关重要。一般而言，孕期克罗恩病的药物治疗与非孕期患者的药物治疗相似。通过药物治疗维持病情缓解的患者在整个孕期都应继续用药。柳氮磺胺吡啶、美沙拉嗪和皮质类固醇是安全的，硫唑嘌呤和6-巯基嘌呤相当安全，仅有少量不一致的数据，英夫利昔单抗似乎也安全，而甲氨蝶呤在孕期禁用。在母乳喂养期间，美沙拉嗪和泼尼松被认为是安全的，硫唑嘌呤/6-巯基嘌呤、布地奈德和英夫利昔单抗可能安全，而甲氨蝶呤禁用。
