Living well with inflammatory bowel disease during pregnancy
Living well with inflammatory bowel disease during pregnancy
Inflammatory bowel diseases (IBD), such as Crohn’s disease and ulcerative colitis, are often diagnosed in young adulthood. As a result, IBD and pregnancy frequently overlap. Pregnancy causes major changes in the body, which can affect both the disease itself and the way medications work. At the same time, active IBD can negatively influence pregnancy outcomes, increasing the risk of complications such as preterm birth or low birth weight. This often leads to uncertainty among patients and healthcare providers about the best treatment approach during pregnancy.
This thesis of Dianne Bouwknegt examines several aspects of care for pregnant women with IBD. Overall, pregnancy is generally feasible and safe for women with IBD. The results show that women whose disease was active shortly before conception have a higher risk of experiencing a disease flare during pregnancy. Therefore, it is important to plan pregnancy during a period of stable remission of at least six months.
In addition, changes in liver enzyme levels and in the blood levels of certain medications during pregnancy are usually the result of normal physiological adaptations and rarely lead to clinically relevant problems. The research also suggests that oxidative stress may play a role in adverse pregnancy outcomes, although further studies are needed. Among women with a stoma, stoma-related complications occurred relatively frequently during pregnancy but were generally manageable.
Finally, this thesis describes the development of a nationwide pregnancy registry for women with IBD. This registry aims to improve knowledge and ultimately support more personalized and evidence-based care for mother and child.