Monitoring inflammatory bowel disease during pregnancy: Current literature and future challenges

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.