Crohn’s disease and pregnancy

Abstract

Crohn’s disease is a chronic transmural granulomatous enteritis of unknown etiology that may affect any part of the gastrointestinal tract, preferentially involving the distal ileum, the colons and the anorectal region. Its course is variable, of a dormant and prolonged nature, with a pattern of exacerbations and remissions. The incidence of Crohn’s disease has greatly increased in the last 30 years, with the absolute majority of cases starting to show clinical manifestations in the second and third decades of life, and with women being affected during their reproductive years. The disease activity in the beginnig of pregnancy is the most important factor affecting both the prognosis of Crohn’s disease and gestational prognosis. Obstetrical complications as spontaneous abortion, preterm delivery, fetal malformation and intrauterus growth retardation happen when the disease is active in the periconceptional period or during the first trimester of pregnancy. In the present review, the authors evaluate the major etiological, clinical and therapeutic aspects of Crohn’s disease during pregnancy, with a detailed discussion of the effects of the disease on pregnancy and the consequences of gestation for the evolution of the disease.