Assessment of Physicians' Perceived Risk of Inflammatory Bowel Disease Medications in Pregnant Patients.

UNLABELLED: Many female patients with inflammatory bowel disease (IBD) are affected during their reproductive years, and the benefits of continuing medical therapy to maintain remission during pregnancy generally outweigh the risks of therapy cessation. Knowledge of the current guidelines is important to maximize maternal and fetal outcomes.

METHODS: A total of 116 practitioners (family medicine [FM], n = 35; internal medicine [IM], n = 22; obstetrics/gynecol-ogy [Ob/Gyn], n=23; gastroenterology [GI], n = 36) responded to a survey. Respondents were asked about the US Food and Drug Administration classifications of common IBD drugs, the need for caution when administering live vaccines to neonates exposed to biologic agents in utero, and 2 scenarios of patients with IBD who wanted to become pregnant.

RESULTS: Compared with GI physicians, FM + IM physicians were less likely to correctly identify infliximab (Remicade, Janssen Biotech) as a pregnancy category B drug (67% vs 30%; P=.0005). Among all respondents, 38% were unaware of the need to delay administration of live vaccines to infants exposed to anti-tumor necrosis factor agents in utero. GI specialists were more likely to advise patients to continue their IBD regimen (biologic agents and thiopurines) during pregnancy than non-GI (IM, FM, and Ob/Gyn) physicians (biologic agents: 86% vs 46%; P<.0001 and thiopurines: 69% vs 15%; P<.0001). Overall, 78% of non-GI physicians said that they would change their practice based on the survey.

CONCLUSION: Practitioners caring for pregnant patients may lack awareness regarding the safety and management of IBD drugs during pregnancy. Bringing awareness through education may increase the number of physicians following best practice guidelines.