Inflammatory Bowel Disease Unit, Department of Gastroenterology, Cumming School of Medicine, University of Calgary, Alberta, Canada; Department of Gastroenterology and Hepatology, Royal Perth Hospital, Perth, Australia.
Inflammatory Bowel Disease Unit, Department of Gastroenterology, Cumming School of Medicine, University of Calgary, Alberta, Canada; Department of Community Health Sciences, University of Calgary, Alberta, Canada.
Best Pract Res Clin Gastroenterol. 2020 Feb-Apr;44-45:101670. doi: 10.1016/j.bpg.2020.101670. Epub 2020 Mar 13.
Active inflammatory bowel disease during conception and pregnancy has been associated with adverse materno-fetal outcomes. Patients are often unduly concerned about the adverse effects of biologic medications on the growing fetus, however, continuing therapy is advised, with potential risks of therapy outweighed by the risks of active maternal disease. A number of physiological changes associated with pregnancy can alter the absorption, distribution and elimination of these therapies, which may impact on their safety and efficacy. We review the current evidence regarding the effects of pregnancy on the pharmacokinetics of biologic therapies, as well as drug concentration measurements during pregnancy and at time of delivery. A greater understanding of the impact of pregnancy on the pharmacokinetics of biologic therapies and the emerging utilisation of drug concentration monitoring during pregnancy may lead to improved materno-fetal outcomes in patients with inflammatory bowel disease.
在受孕和妊娠期间出现活动性炎症性肠病与不良的母婴结局相关。然而，患者往往过分担心生物药物对胎儿发育的不良影响，建议继续治疗，因为治疗的潜在风险大于母体疾病的活动风险。与妊娠相关的许多生理变化会改变这些治疗方法的吸收、分布和消除，从而影响其安全性和疗效。我们回顾了关于妊娠对生物治疗药物药代动力学影响的现有证据，以及妊娠期间和分娩时的药物浓度测量。更深入地了解妊娠对生物治疗药物药代动力学的影响，以及妊娠期间药物浓度监测的新兴应用，可能会改善炎症性肠病患者的母婴结局。
