December 03, 2019
1 min read

Women with IBD more likely to adhere to biologics during pregnancy

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Women with inflammatory bowel disease were more likely to adhere to biologic therapy during pregnancy than other drug classes, according to study results.

Amy Metcalfe, PhD, of the department of obstetrics & gynecology at the University of Calgary, and colleagues wrote that many women with IBD often perceive an increased risk for complications during their pregnancy due to their medications. However, these risks are often overestimated.

“Due to these misconceptions about IBD medications, women may completely stop taking their medications during pregnancy or take a lower dosage of medication than prescribed,” they wrote. “Both of these situations increase the risk of disease flare, which is an independent risk factor of adverse maternal and fetal outcomes.”

Researchers assessed medication adherence patterns using data from 230 women who had at least two consecutive medication prescriptions for maintenance of IBD in the year prior to pregnancy.

Of 159 women who adhered to their therapy in the year prior to pregnancy, 20 were not adherent (12.6%), and 21 discontinued therapy completely (13.2%) during their pregnancy.

However, adherence during pregnancy differed between drug classes. Metcalfe and colleagues found that women were more likely to be adherent to biologics (49.3%; 95% CI, 37.3%–61.3%) than thiopurines (20.9%; 95% CI, 12.6%–32.6%) or 5-aminosalicylates (29.9%; 95% CI, 19.9%–42.1%) in the first trimester. Although there was no difference in adherence in the second trimester, the difference in the third was similar to the first.

While babies born to women with IBD were more likely to be admitted to the neonatal intensive care unit than the general population, the rates among babies born to mothers with IBD who were adherent nor non-adherent to their medication were not significantly different.

Metcalfe and colleagues wrote that medication non-adherence could be an important modifiable risk factor than can be addressed to improve pregnancy outcomes.

“Maternal education prior to and during pregnancy influences a woman's perception regarding the risks and benefits of medication use during pregnancy and thus, their adherence to medical therapy,” they wrote. “Variability in antenatal care and counseling may be a factor in the differing medication adherence rates.” – by Alex Young

Disclosures: Metcalfe reports being supported by a New Investigators Award from the Canadian Institutes of Health Research. Please see the full study for all other authors’ relevant financial disclosures.