Division of Gastroenterology and Hepatology, Department of Medicine, University of California San Francisco, San Francisco, CA, USA.
Nat Rev Gastroenterol Hepatol. 2023 Aug;20(8):504-523. doi: 10.1038/s41575-023-00758-3. Epub 2023 Mar 31.
Inflammatory bowel disease (IBD) has a peak age of diagnosis before the age of 35 years. Concerns about infertility, adverse pregnancy outcomes, and heritability of IBD have influenced decision-making for patients of childbearing age and their care providers. The interplay between the complex physiology in pregnancy and IBD can affect placental development, microbiome composition and responses to therapy. Current evidence has shown that effective disease management, including pre-conception counselling, multidisciplinary care and therapeutic agents to minimize disease activity, can improve pregnancy outcomes. This Review outlines the management of IBD in pregnancy and the safety of IBD therapies, including novel agents, with regard to both maternal and fetal health. The vast majority of IBD therapies can be used with low risk during pregnancy and lactation without substantial effects on neonatal outcomes.
炎症性肠病（IBD）的诊断高峰年龄在 35 岁之前。对生育能力、不良妊娠结局和 IBD 的遗传性的担忧，影响了育龄患者及其护理人员的决策。妊娠期间复杂的生理机能与 IBD 之间的相互作用会影响胎盘发育、微生物组组成和对治疗的反应。现有证据表明，有效的疾病管理，包括孕前咨询、多学科护理和使用可最大程度降低疾病活动度的治疗药物，可改善妊娠结局。本综述概述了妊娠期间 IBD 的管理，以及 IBD 治疗药物的安全性，包括新型药物，涉及母婴健康。绝大多数 IBD 治疗药物在妊娠和哺乳期使用风险低，对新生儿结局没有显著影响。
