Importance of appropriate pharmaceutical management in pregnant women with ulcerative colitis

Masaki Ujihara, Takafumi Ando, Kazuhiro Ishiguro, Osamu Maeda, Osamu Watanabe, Yutaka Hirayama, Kazuhiro Morise, Keiko Maeda, Masanobu Matsushita, Ryoji Miyahara, Naoki Omiya, Yuji Nishio, Takeo Yamaguchi, Jun Ichi Haruta, Kenji Ina, Hidemi Goto

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Abstract

Background: Ulcerative colitis (UC) often occurs in women of childbearing age. Compared to Western countries, however, few studies have investigated the impact of UC on the progress of pregnancy in Asian populations. Methods. We retrospectively examined 91 pregnancies in 64 patients with UC experienced at our hospital and related institutions from 1991 to 2011, focusing on the relationship between the progression of UC during pregnancy, progress of the pregnancy itself, and the treatment of UC. Results: In 80 of 91 pregnancies the patient had already been diagnosed with UC at the time she became pregnant, of whom 31 (38.8%) experienced exacerbation during pregnancy. Regarding severity, moderate or severe active-stage disease during pregnancy was seen in 13.7% of those who had been in remission at the onset of pregnancy versus 58.6% of those who had been in the active stage at onset (OR 8.9: 95%CI 3.0∼26.4; P<0.01). The incidence of miscarriage or abortion was 9.8% in pregnancies in which UC was in remission at onset versus 31% in those in which it was in the active stage at onset (OR 4.1: 95%CI 1.2∼13.9; P=0.02). Among patients, 62.5% were receiving pharmaceutical treatment at onset of pregnancy. Exacerbation during pregnancy occurred in 26.5% of the group who continued to receive the same treatment during pregnancy versus 56.3% of those with a dose decrease or discontinuation after onset (OR 3.6: 95%CI 1.0∼12.4; P=0.04). Conclusions: UC patients wishing to conceive should do so when in remission and continue appropriate pharmaceutical treatment during pregnancy.

Original languageEnglish
Article number210
JournalBMC Research Notes
Volume6
Issue number1
DOIs
Publication statusPublished - 28-05-2013

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Ulcerative Colitis
Pregnant Women
Pregnancy
Pharmaceutical Preparations
Spontaneous Abortion
Therapeutics

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)

Cite this

Ujihara, M., Ando, T., Ishiguro, K., Maeda, O., Watanabe, O., Hirayama, Y., ... Goto, H. (2013). Importance of appropriate pharmaceutical management in pregnant women with ulcerative colitis. BMC Research Notes, 6(1), [210]. https://doi.org/10.1186/1756-0500-6-210
Ujihara, Masaki ; Ando, Takafumi ; Ishiguro, Kazuhiro ; Maeda, Osamu ; Watanabe, Osamu ; Hirayama, Yutaka ; Morise, Kazuhiro ; Maeda, Keiko ; Matsushita, Masanobu ; Miyahara, Ryoji ; Omiya, Naoki ; Nishio, Yuji ; Yamaguchi, Takeo ; Haruta, Jun Ichi ; Ina, Kenji ; Goto, Hidemi. / Importance of appropriate pharmaceutical management in pregnant women with ulcerative colitis. In: BMC Research Notes. 2013 ; Vol. 6, No. 1.
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title = "Importance of appropriate pharmaceutical management in pregnant women with ulcerative colitis",
abstract = "Background: Ulcerative colitis (UC) often occurs in women of childbearing age. Compared to Western countries, however, few studies have investigated the impact of UC on the progress of pregnancy in Asian populations. Methods. We retrospectively examined 91 pregnancies in 64 patients with UC experienced at our hospital and related institutions from 1991 to 2011, focusing on the relationship between the progression of UC during pregnancy, progress of the pregnancy itself, and the treatment of UC. Results: In 80 of 91 pregnancies the patient had already been diagnosed with UC at the time she became pregnant, of whom 31 (38.8{\%}) experienced exacerbation during pregnancy. Regarding severity, moderate or severe active-stage disease during pregnancy was seen in 13.7{\%} of those who had been in remission at the onset of pregnancy versus 58.6{\%} of those who had been in the active stage at onset (OR 8.9: 95{\%}CI 3.0∼26.4; P<0.01). The incidence of miscarriage or abortion was 9.8{\%} in pregnancies in which UC was in remission at onset versus 31{\%} in those in which it was in the active stage at onset (OR 4.1: 95{\%}CI 1.2∼13.9; P=0.02). Among patients, 62.5{\%} were receiving pharmaceutical treatment at onset of pregnancy. Exacerbation during pregnancy occurred in 26.5{\%} of the group who continued to receive the same treatment during pregnancy versus 56.3{\%} of those with a dose decrease or discontinuation after onset (OR 3.6: 95{\%}CI 1.0∼12.4; P=0.04). Conclusions: UC patients wishing to conceive should do so when in remission and continue appropriate pharmaceutical treatment during pregnancy.",
author = "Masaki Ujihara and Takafumi Ando and Kazuhiro Ishiguro and Osamu Maeda and Osamu Watanabe and Yutaka Hirayama and Kazuhiro Morise and Keiko Maeda and Masanobu Matsushita and Ryoji Miyahara and Naoki Omiya and Yuji Nishio and Takeo Yamaguchi and Haruta, {Jun Ichi} and Kenji Ina and Hidemi Goto",
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Ujihara, M, Ando, T, Ishiguro, K, Maeda, O, Watanabe, O, Hirayama, Y, Morise, K, Maeda, K, Matsushita, M, Miyahara, R, Omiya, N, Nishio, Y, Yamaguchi, T, Haruta, JI, Ina, K & Goto, H 2013, 'Importance of appropriate pharmaceutical management in pregnant women with ulcerative colitis', BMC Research Notes, vol. 6, no. 1, 210. https://doi.org/10.1186/1756-0500-6-210

Importance of appropriate pharmaceutical management in pregnant women with ulcerative colitis. / Ujihara, Masaki; Ando, Takafumi; Ishiguro, Kazuhiro; Maeda, Osamu; Watanabe, Osamu; Hirayama, Yutaka; Morise, Kazuhiro; Maeda, Keiko; Matsushita, Masanobu; Miyahara, Ryoji; Omiya, Naoki; Nishio, Yuji; Yamaguchi, Takeo; Haruta, Jun Ichi; Ina, Kenji; Goto, Hidemi.

In: BMC Research Notes, Vol. 6, No. 1, 210, 28.05.2013.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Importance of appropriate pharmaceutical management in pregnant women with ulcerative colitis

AU - Ujihara, Masaki

AU - Ando, Takafumi

AU - Ishiguro, Kazuhiro

AU - Maeda, Osamu

AU - Watanabe, Osamu

AU - Hirayama, Yutaka

AU - Morise, Kazuhiro

AU - Maeda, Keiko

AU - Matsushita, Masanobu

AU - Miyahara, Ryoji

AU - Omiya, Naoki

AU - Nishio, Yuji

AU - Yamaguchi, Takeo

AU - Haruta, Jun Ichi

AU - Ina, Kenji

AU - Goto, Hidemi

PY - 2013/5/28

Y1 - 2013/5/28

N2 - Background: Ulcerative colitis (UC) often occurs in women of childbearing age. Compared to Western countries, however, few studies have investigated the impact of UC on the progress of pregnancy in Asian populations. Methods. We retrospectively examined 91 pregnancies in 64 patients with UC experienced at our hospital and related institutions from 1991 to 2011, focusing on the relationship between the progression of UC during pregnancy, progress of the pregnancy itself, and the treatment of UC. Results: In 80 of 91 pregnancies the patient had already been diagnosed with UC at the time she became pregnant, of whom 31 (38.8%) experienced exacerbation during pregnancy. Regarding severity, moderate or severe active-stage disease during pregnancy was seen in 13.7% of those who had been in remission at the onset of pregnancy versus 58.6% of those who had been in the active stage at onset (OR 8.9: 95%CI 3.0∼26.4; P<0.01). The incidence of miscarriage or abortion was 9.8% in pregnancies in which UC was in remission at onset versus 31% in those in which it was in the active stage at onset (OR 4.1: 95%CI 1.2∼13.9; P=0.02). Among patients, 62.5% were receiving pharmaceutical treatment at onset of pregnancy. Exacerbation during pregnancy occurred in 26.5% of the group who continued to receive the same treatment during pregnancy versus 56.3% of those with a dose decrease or discontinuation after onset (OR 3.6: 95%CI 1.0∼12.4; P=0.04). Conclusions: UC patients wishing to conceive should do so when in remission and continue appropriate pharmaceutical treatment during pregnancy.

AB - Background: Ulcerative colitis (UC) often occurs in women of childbearing age. Compared to Western countries, however, few studies have investigated the impact of UC on the progress of pregnancy in Asian populations. Methods. We retrospectively examined 91 pregnancies in 64 patients with UC experienced at our hospital and related institutions from 1991 to 2011, focusing on the relationship between the progression of UC during pregnancy, progress of the pregnancy itself, and the treatment of UC. Results: In 80 of 91 pregnancies the patient had already been diagnosed with UC at the time she became pregnant, of whom 31 (38.8%) experienced exacerbation during pregnancy. Regarding severity, moderate or severe active-stage disease during pregnancy was seen in 13.7% of those who had been in remission at the onset of pregnancy versus 58.6% of those who had been in the active stage at onset (OR 8.9: 95%CI 3.0∼26.4; P<0.01). The incidence of miscarriage or abortion was 9.8% in pregnancies in which UC was in remission at onset versus 31% in those in which it was in the active stage at onset (OR 4.1: 95%CI 1.2∼13.9; P=0.02). Among patients, 62.5% were receiving pharmaceutical treatment at onset of pregnancy. Exacerbation during pregnancy occurred in 26.5% of the group who continued to receive the same treatment during pregnancy versus 56.3% of those with a dose decrease or discontinuation after onset (OR 3.6: 95%CI 1.0∼12.4; P=0.04). Conclusions: UC patients wishing to conceive should do so when in remission and continue appropriate pharmaceutical treatment during pregnancy.

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U2 - 10.1186/1756-0500-6-210

DO - 10.1186/1756-0500-6-210

M3 - Article

VL - 6

JO - BMC Research Notes

JF - BMC Research Notes

SN - 1756-0500

IS - 1

M1 - 210

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