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World J Gastrointest Pharmacol Ther. Feb 6, 2018; 9(1): 1-7
Published online Feb 6, 2018. doi: 10.4292/wjgpt.v9.i1.1
Monitoring inflammatory bowel disease during pregnancy: Current literature and future challenges
Tenzin Choden, Rohan Mandaliya, Aline Charabaty, Mark C Mattar
Tenzin Choden, Department of Internal Medicine, MedStar Georgetown University Hospital, Washington, DC 20007, United States
Rohan Mandaliya, Aline Charabaty, Mark C Mattar, Division of Gastroenterology, MedStar Georgetown University Hospital, Washington, DC 20007, United States
Author contributions: Choden T and Mandaliya R wrote the manuscript; Charabaty A and Mattar MC provided input on designing the outline and coordinated the writing of the paper.
Conflict-of-interest statement: There is no conflict of interest associated with any of the senior author or other coauthors contributed their efforts in this manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Mark C Mattar, MD, FACG, Division of Gastroenterology, MedStar Georgetown University Hospital, 3800 Reservoir Rd NW, Washington, DC 20007, United States. mark.c.mattar@gunet.georgetown.edu
Telephone: +1-202-4441039 Fax: +1-877-3031462
Received: July 29, 2017
Peer-review started: July 30, 2017
First decision: September 6, 2017
Revised: October 13, 2017
Accepted: October 30, 2017
Article in press: October 30, 2017
Published online: February 6, 2018
Processing time: 187 Days and 12.1 Hours
Abstract

Inflammatory bowel disease has a high prevalence in women of childbearing age and can have a significant impact on pregnancy, from conceiving to carrying the pregnancy. Active disease during pregnancy is known to have negative effects on pregnancy outcomes; therefore, careful monitoring during this period is an important but challenging aspect of care and is crucial as it affects important management decisions. Recent data seems to suggest that endoscopy is a relatively safe procedure during all trimesters of pregnancy. Serum biomarkers such as C-reactive protein and fecal calprotectin are helpful non-invasive markers, but have shown conflicting results for correlation with disease activity in some initial studies. Further work is necessary to establish standard of care monitoring during pregnancy.

Keywords: Inflammatory bowel disease; Crohn’s disease; Ulcerative colitis; Pregnancy; Fecal calprotectin

Core tip: This review article fills in the gap in the paucity of literature specifically focusing on the monitoring of inflammatory bowel disease during pregnancy. New and emerging literature on the use of non-invasive biomarkers such as fecal calprotectin is discussed, but classic monitoring techniques such as endoscopy and radiographic imaging are also evaluated within the scope of pregnancy.