Enhancing Crohn's disease management during pregnancy: innovations in therapeutic approaches and cutting-edge monitoring practices

Abstract

Objective To evaluate the current practices and highlight the importance of ongoing innovation in managing Crohn's disease (CD) during pregnancy. Methods A prospective observational study was conducted at Kanuni Sultan Suleyman Training and Research Hospital, encompassing patients managed from 2023 to 2024. The study included 43 pregnant women diagnosed with Crohn's disease who were monitored throughout the prepartum and postpartum periods. Clinical data regarding disease duration, medication use, intestinal surgery history, maternal complications, and neonatal outcomes were collected and analyzed. Key variables included the need for a neonatal intensive care unit (NICU), gestational age at delivery, mode of delivery, and neonatal birth weight. Results A cohort of 43 patients with Crohn's disease was analyzed for maternal and neonatal outcomes. The median age of the cohort was 33.7 +/- 4.8 years, with a median disease duration of 6.8 +/- 3.9 years. Vaginal delivery (VD) was achieved in 51.2% of cases, while 48.8% required a cesarean section. Assisted reproductive techniques (ART) were used in 9.4% of patients. Maternal complications included gestational diabetes (2.3%), gestational hypertension (4.7%), cervical insufficiency (2.3%), and intrauterine fetal death (4.7%). Premature birth (< 37 weeks) occurred in 11.6% of cases, and 25.6% of newborns required NICU admission. Notably, 20.9% of patients had a history of intestinal surgery, and 37.1% received medications such as corticosteroids, antibiotics, or infliximab. Conclusion Pregnant women with Crohn's disease generally have favorable outcomes, especially when disease activity is well-controlled. Active disease during pregnancy, however, is associated with increased maternal and neonatal complications. Close monitoring and individualized management are crucial to optimizing pregnancy outcomes in this population.