CHU de Saint-Étienne, Service d’Hépato-Gastro-Entérologie, Avenue Albert Raimond, 42270 Saint-Priest-en-Jarez
Women with Inflammatory Bowel Disease (IBD) are preoccupied about their medication exposure during pregnancy and their effects on the fetus. The management of biologics before, during and after pregnancy is quickly changing, that is why the doctors who take care for this patient population should be well informed and feel comfortable counselling their patients for the best possible pregnancy outcome.
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 knowledge provided by previous researches on the safety of biologics during pregnancy is reassuring. With the advent of new biologics with different mechanisms of action but similar protein structure, IgG1 antibodies, it is expected that the recommendation of continuation of therapy throughout pregnancy will be sustained.