Contraception, Venous Thromboembolism, and Inflammatory Bowel Disease: What Clinicians (and Patients) Should Know

被引:20
|
作者
Limdi, Jimmy K. [1 ,2 ]
Farraye, Jennifer [3 ]
Cannon, Rachel [3 ]
Woodhams, Elisabeth [3 ]
Farraye, Francis A. [4 ]
机构
[1] Pennine Acute Hosp NHS Trust, Head Inflammatory Bowel Dis Sect, Manchester, Lancs, England
[2] Univ Manchester, Manchester Acad Hlth Sci, Manchester, Lancs, England
[3] Boston Med Ctr, Dept Obstet & Gynecol, Boston, MA USA
[4] Boston Med Ctr, Sect Gastroenterol, Boston, MA USA
关键词
inflammatory bowel disease; Crohn's; ulcerative colitis; contraception; thromboembolism; EVIDENCE-BASED CONSENSUS; ORAL-CONTRACEPTIVES; CROHNS-DISEASE; ULCERATIVE-COLITIS; RISK-FACTORS; HORMONAL CONTRACEPTION; PREGNANCY INTENTIONS; UNITED-STATES; WOMEN; MANAGEMENT;
D O I
10.1093/ibd/izz025
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
The peak incidence of the inflammatory bowel diseases (IBDs) is between the second and fourth decades of life, which coincides with prime reproductive years. Unplanned or mistimed pregnancies may account for nearly half of all pregnancies and are associated with adverse consequences such as a higher risk of delayed preconceptual care, increased risk of preterm birth, low birth weight, and adverse maternal and neonatal outcomes. Increased IBD activity during pregnancy is also associated with adverse pregnancy-related outcomes, such as miscarriage, intrauterine growth retardation, and preterm birth. Furthermore, the increased risk of venous thromboembolism (VTE) conferred by active IBD may be potentially augmented by hormonal contraceptives. Recent literature suggests that women with IBD seek counseling on contraception from gastroenterologists in preference to their primary care physicians. Meanwhile, attitudes and awareness regarding contraception counseling remain suboptimal, underpinning the importance and need for physician and patient education in this area. We discuss the association between contraception and IBD, benefits and risks associated with various contraceptive methods in women with IBD, and practical recommendations for clinicians caring for women with IBD.
引用
收藏
页码:1603 / 1612
页数:10
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