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Rana Ahmad
Lit Review outline
Crohn’s Disease in Women
Crohn’s disease is a chronic inflammatory disease characterized by the tendency of chronic or relapsing activation of the immune system within the gastrointestinal tract. (1)
Does Crohn’s Disease affect fertility and pregnancy in women? Inflammatory bowel disease affects women in their productive years and can influence fertility, pregnancy and decisions regarding breastfeeding. (2) Over time, this can progress to complications of stricture, fistulas, or abscesses. (1)
The disease begins within the digestive tract, with a tendency to develop in the distal small bowel and proximal large bowel. Early features of this disease usually include diarrhea, fever, weight loss, and abdominal pain. (1)
Microorganisms, including pathogens and members of the original microbiota, may initiate the inflammatory process in Crohn’s disease. (3)
The exposure to potential pathogens in the gut may be temporary and may occur prior to the onset of clinical disease. Microbial contact may be confined to parts of the digestive tract that are relatively inaccessible to tissue sampling, such as the ileum or jejunum. (3) Some of the assumed pathophysiological mechanisms include increased intestinal permeability, vascular abnormalities, infectious agents, abnormal immunological response, production of autoantibodies, and proinflammatory molecules, which can all lead to malnutrition (which is common with those who have Crohn’s disease).(4)
Active disease during pregnancy has been linked to adverse pregnancy outcomes of low birth weight, pre-term birth and fetal loss .(5) Patients with IBD were more likely to have a caesarean section. (6)
Conclude-Women with Crohn’s disease becomes a high risk with many complications when they desire to have kids at a childbearing age.
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References
Plavši? I, Štimac T, Hauser G. Crohn’s disease in women. International Journal of Women’s Health. 2013;5:681-688. doi:10.2147/IJWH.S38083.
Selinger CP, Leong RW, Lal S. Pregnancy related issues in inflammatory bowel disease: Evidence base and patients’ perspective. World Journal of Gastroenterology?: WJG. 2012;18(21):2600-2608. doi:10.3748/wjg.v18.i21.2600.
Eckburg PB, Relman DA. The role of microbes in crohn’s disease. Clinical
Nørgård B, Hundborg HH, Jacobsen BA, Nielsen GL, Fonager K. Disease activity in pregnant women with Crohn’s disease and birth outcomes: a regional Danish cohort study. Am J Gastroenterol.2007;102:1947–1954.
Infectious Diseases. 2007;44(2):256-262.
Coelho J, Beaugerie L, Colombel JF, et al. Pregnancy outcome in patients wit

h inflammatory bowel disease treated with thiopurines: cohort from the CESAME Study. Gut. 2011;60:198–203.
Cornish J, Tan E, Teare J, Teoh TG, Rai R, Clark SK, Tekkis PP. A meta-analysis on the influence of inflammatory bowel disease on pregnancy. Gut. 2007;56:830–837.
Ruffolo C, Citton M, Scarpa M, et al. Perianal Crohn’s disease: Is there something new? World Journal of Gastroenterology?: WJG. 2011;17(15):1939-1946. doi:10.3748/wjg.v17.i15.1939.
Implications of Infliximab Treatment Failure and Influence of Personalized Treatment on Patient-reported Health-related Quality of Life and Productivity Outcomes in Crohn’s Disease
Colombel JF, Sandborn WJ, Reinisch W, et al. Infliximab, azathioprine, or combination therapy for crohn’s disease. N Engl J Med. 2010;362(15):1383-1395.
Reddy D, Murphy SJ, Kane SV, Present DH, Kornbluth AA. Relapses of inflammatory bowel disease during pregnancy: in-hospital management and birth outcomes. Am J Gastroenterol. 2008;103:1203–1209.
van der Woude CJ, Ardizzone S, Bengtson MB, et al. The second European evidenced-based consensus on reproduction and pregnancy in inflammatory bowel disease. J Crohns Colitis. 2015;9:107–124.
Moskovitz DN, Bodian C, Chapman ML, Marion JF, Rubin PH, Scherl E, Present DH. The effect on the fetus of medications used to treat pregnant inflammatory bowel-disease patients. Am J Gastroenterol.2004;99:656–661.
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