Inflammatory Bowel Disease Drugs Don’t Harm Fetus

Medications used to treat inflammatory bowel disease (IBD) in pregnant women do not appear to harm the fetus, according to a report in the American Journal of Gastroenterology. A number of drugs are used to induce and maintain remission in patients with IBD, the authors explain, but there are few studies that have evaluated the effect of these medications on pregnancy outcome.

Medications used to treat inflammatory bowel disease (IBD) in pregnant women do not appear to harm the fetus, according to a report in the American Journal of Gastroenterology. A number of drugs are used to induce and maintain remission in patients with IBD, the authors explain, but there are few studies that have evaluated the effect of these medications on pregnancy outcome. Dr. Daniel H. Present from Mount Sinai School of Medicine, New York and colleagues examined the possible effects of 5-aminosalicylic acid (5-ASA), metronidazole, ciprofloxacin, prednisone, 6-mercaptopurine, azathioprine, and cyclosporine on pregnancy outcome in 39 women with ulcerative colitis, 73 with Crohn’s disease, and 1 with indeterminate colitis. In 113 patients, the authors report, there were 16 spontaneous abortions, 6 premature deliveries, 2 ectopic pregnancies, 1 multiple birth, and 86 full-term deliveries. Three infants had major defects, including a heart defect and immature lungs. “We observed a malformation rate of 2.9%, a number consistent with that seen in the general population,” the investigators write. “Prior literature reports have shown the rate of spontaneous abortion to be similar in IBD patients.” They observed no association between any of the drugs or drug classes and unsuccessful pregnancy outcome. Additional analyzes that examined the use of the drugs alone or in combinations similarly showed no association between drug use and unsuccessful pregnancy outcome. “The main concern in previous studies as well as ours has been the inability to make definite statements about safety due to small numbers of patients,” the authors caution. “Until further information is available we advise no pregnancy should be attempted unless the patient is in clinical remission on adequate medication.” (Source: Reuters Health, American Journal of Gastroenterology, May 2004)