Crohn's Disease and Pregnancy
Can Pregnant Women Take Medication for Crohn's Disease?
With or without Crohn's disease, you need to discuss all your medications with your doctor when you are pregnant. In general, medication for Crohn's disease does not change during pregnancy. It might, though, if you have a change in your condition. As for specific types of drugs to treat Crohn's disease, only antibiotics and methotrexate must be avoided. That's because of the harm they can do to the fetus.
Drugs in the aminosalicylate class (5-ASA drugs) do not damage the fetus or increase the risk of complications. These drugs include:
In addition, if you are taking a 5-ASA drug, you will be able to breastfeed safely.
If you are on steroids, you should not get pregnant. If you are taking a corticosteroid such as prednisone or another steroid and do get pregnant, your doctor will prescribe the smallest possible dose. If you are breastfeeding while taking steroids in moderate to high doses, your baby should be monitored by a pediatrician.
Drugs that affect the immune system are called immunomodulators and immunosuppressives. These drugs do not seem to cause problems during pregnancy when they are used in standard dosages. The exception is methotrexate. Methotrexate should not be taken if you are pregnant. Nor should it be taken by either a man or a woman who is trying to conceive. Methotrexate can cause the death of the fetus. It can also cause congenital abnormalities. If you are taking methotrexate, you also should not breastfeed.
Biologic drugs such as infliximab (Remicade) and adalimumab (Humira) seem to be safe for use during pregnancy. They also do not appear to be secreted in breast milk.
If you are taking vitamins before becoming pregnant, you can continue taking them. If you are taking sulfasalazine, you need to be particularly sure you get enough folic acid. Folic acid prevents neural tube birth defects such as spina bifida. Sulfasalazine blocks the absorption of folic acid.
Should Pregnant Women Undergo Testing for Crohn's Disease?
When you are pregnant and have Crohn's disease, you may safely undergo any of the following if they're needed:
- upper endoscopy
- rectal biopsy
- abdominal ultrasound
X-rays and CT (computed tomography) scans, though, should be avoided unless absolutely necessary. MRI (magnetic resonance imaging) scans appear to be safe during pregnancy.