- Fecal Incontinence
|Contraception, Venous Thromboembolism, and Inflammatory Bowel Disease: What Clinicians (and Patients) Should Know
Limdi JK1,2, Farraye J3, Cannon R3, Woodhams E3, Farraye FA4. Inflamm Bowel Dis. 2019 Mar 16. pii: izz025. doi: 10.1093/ibd/izz025. [Epub ahead of print]
1 Head-Inflammatory Bowel Diseases Section, The Pennine Acute Hospitals NHS Trust, Manchester, United Kingdom.
2 Manchester Academic Health Sciences, University of Manchester, Manchester, United Kingdom.
3 Department of Obstetrics and Gynecology, Boston Medical Center, Boston, Massachusetts.
4 Section of Gastroenterology, Boston Medical Center, Boston, Massachusetts.
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.