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生物制剂与妊娠:孕妇中炎症性肠病管理的临床医生指南。

Biologics and pregnancy: a clinician's guide to the management of IBD in pregnant women.

机构信息

Division of Gastroenterology and Hepatology, Mayo Clinic Rochester, Rochester, MN, USA.

出版信息

Expert Rev Gastroenterol Hepatol. 2021 Jun;15(6):633-641. doi: 10.1080/17474124.2021.1876562. Epub 2021 Jan 25.

Abstract

: Women with inflammatory bowel disease (IBD) endorse a tremendous amount of concern about medication exposure during pregnancy and their effects on the fetus. Medical providers caring for this patient population should be well informed and feel comfortable counseling their patients for the best pregnancy outcome possible.: It is of particular importance to understand the implications of use of biologics in preconception, pregnancy, and postpartum timeframes. Herein, we aim to inform the clinician about the impact of uncontrolled inflammation during pregnancy, the mechanisms of biologic transport through the placenta, the effects of biologics in maternal and neonatal outcomes, and additional postpartum considerations such as breastfeeding and vaccination safety.: The groundwork already set by previous research in terms of safety of biologic therapy during pregnancy has been reassuring. With the advent of more mechanisms of action but similar protein structure, i.e. they are IgG1 antibodies; the authors anticipate the recommendation of continuation of therapy throughout pregnancy will be sustained.

摘要

: 患有炎症性肠病 (IBD) 的女性非常关注怀孕期间药物暴露及其对胎儿的影响。照顾这一患者群体的医疗服务提供者应该充分了解情况,并为患者提供最佳的妊娠结局提供舒适的咨询。: 了解生物制剂在受孕前、妊娠和产后期间的使用意义尤其重要。在此,我们旨在告知临床医生怀孕期间未得到控制的炎症的影响、生物制剂通过胎盘的转运机制、生物制剂对母婴结局的影响,以及产后如母乳喂养和疫苗接种安全性等其他方面的考虑因素。: 之前的研究已经为怀孕期间生物治疗的安全性奠定了基础,结果令人欣慰。随着作用机制的出现以及类似的蛋白质结构,即 IgG1 抗体,作者预计将维持整个孕期继续治疗的建议。

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