Management of Pregnant Inflammatory Bowel Disease Patients During the COVID-19 Pandemic

Abstract The rapid emergence of the novel coronavirus [SARS-CoV2] and the coronavirus disease 2019 [COVID-19] has caused significant global morbidity and mortality. This is particularly concerning for vulnerable groups such as pregnant women with inflammatory bowel disease [IBD]. Care for pregnant IBD patients in itself is a complex issue because of the delicate balance between controlling maternal IBD as well as promoting the health of the unborn child. This often requires continued immunosuppressive maintenance medication or the introduction of new IBD medication during pregnancy. The current global COVID-19 pandemic creates an additional challenge in the management of pregnant IBD patients. In this paper we aimed to answer relevant questions that can be encountered in daily clinical practice when caring for pregnant women with IBD during the current COVID-19 pandemic. Podcast This article has an associated podcast which can be accessed at https://academic.oup.com/ecco-jcc/pages/podcast

[1]  M. Aslan,et al.  Correlation of chest CT and RT-PCR testing in coronavirus disease 2019 (COVID-19) in Turkey , 2021, Annals of Clinical and Analytical Medicine.

[2]  D. Wichmann.  Autopsy Findings and Venous Thromboembolism in Patients With COVID-19 , 2020, Annals of Internal Medicine.

[3]  M. Westgren,et al.  Letter to Editor: Intensive Care Unit Admissions for Pregnant and Non-Pregnant Women with COVID-19 , 2020, American Journal of Obstetrics and Gynecology.

[4]  A. Carnahan,et al.  Public Health Agency of Sweden's Brief Report: Pregnant and postpartum women with severe acute respiratory syndrome coronavirus 2 infection in intensive care in Sweden , 2020, Acta Obstetricia et Gynecologica Scandinavica.

[5]  Yu Chen,et al.  Lack of Vertical Transmission of Severe Acute Respiratory Syndrome Coronavirus 2, China , 2020, Emerging infectious diseases.

[6]  C. Henderson,et al.  Letter to the Editor: Screening All Pregnant Women Admitted To Labor And Delivery For The Virus Responsible For COVID-19 , 2020, American Journal of Obstetrics and Gynecology.

[7]  D. Rubin,et al.  Management of Acute Severe Ulcerative Colitis in a Pregnant Woman With COVID-19 Infection: A Case Report and Review of the Literature , 2020, Inflammatory bowel diseases.

[8]  A. Carnahan,et al.  Public Health Agency of Sweden's Brief Report: Pregnant and postpartum women with severe acute respiratory syndrome coronavirus 2 infection in intensive care in Sweden , 2020, Acta obstetricia et gynecologica Scandinavica.

[9]  B. Schwartz,et al.  Acute Respiratory Distress Syndrome in a Preterm Pregnant Patient With Coronavirus Disease 2019 (COVID-19). , 2020, Obstetrics and gynecology.

[10]  A. Shennan,et al.  Placental abruption in a twin pregnancy at 32 weeks’ gestation complicated by coronavirus disease 2019 without vertical transmission to the babies , 2020, American Journal of Obstetrics & Gynecology MFM.

[11]  S. Srinivas,et al.  Clinical course of severe and critical coronavirus disease 2019 in hospitalized pregnancies: a United States cohort study , 2020, American Journal of Obstetrics & Gynecology MFM.

[12]  J. Gubatan,et al.  SARS-CoV-2 Testing, Prevalence, and Predictors of COVID-19 in Patients with Inflammatory Bowel Disease in Northern California , 2020, Gastroenterology.

[13]  F. Chervenak,et al.  Intensive care unit admissions for pregnant and nonpregnant women with coronavirus disease 2019 , 2020, American Journal of Obstetrics and Gynecology.

[14]  M. Aepfelbacher,et al.  Autopsy Findings and Venous Thromboembolism in Patients With COVID-19 , 2020, Annals of Internal Medicine.

[15]  Dunjin Chen,et al.  Critically ill pregnant patient with COVID‐19 and neonatal death within two hours of birth , 2020, International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics.

[16]  S. Srinivas,et al.  Care of critically ill pregnant patients with coronavirus disease 2019: a case series , 2020, American Journal of Obstetrics and Gynecology.

[17]  D. Gommers,et al.  Confirmation of the high cumulative incidence of thrombotic complications in critically ill ICU patients with COVID-19: An updated analysis , 2020, Thrombosis Research.

[18]  L. Peyrin-Biroulet,et al.  Incidence and Patterns of COVID-19 Among Inflammatory Bowel Disease Patients From the Nancy and Milan Cohorts , 2020, Clinical Gastroenterology and Hepatology.

[19]  Xiao-yan He,et al.  Analysis of vaginal delivery outcomes among pregnant women in Wuhan, China during the COVID‐19 pandemic , 2020, International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics.

[20]  S. Ng,et al.  Review article: prevention, diagnosis and management of COVID‐19 in the IBD patient , 2020, Alimentary pharmacology & therapeutics.

[21]  A. Neimann,et al.  Covid-19 in Immune-Mediated Inflammatory Diseases — Case Series from New York , 2020, The New England journal of medicine.

[22]  K. Aagaard,et al.  Maternal death due to COVID-19 , 2020, American Journal of Obstetrics and Gynecology.

[23]  E. Ferrazzi,et al.  Vaginal delivery in SARS‐CoV‐2‐infected pregnant women in Northern Italy: a retrospective analysis , 2020, BJOG : an international journal of obstetrics and gynaecology.

[24]  Shirong Li,et al.  Coronavirus disease 2019 in pregnancy , 2020, International Journal of Infectious Diseases.

[25]  M. Pian-Smith,et al.  Evidence of mother-to-newborn infection with COVID-19 , 2020, British Journal of Anaesthesia.

[26]  A. Vintzileos,et al.  Screening all pregnant women admitted to labor and delivery for the virus responsible for coronavirus disease 2019 , 2020, American Journal of Obstetrics and Gynecology.

[27]  Cuifang Fan,et al.  Coronavirus disease 2019 in pregnant women: a report based on 116 cases , 2020, American Journal of Obstetrics and Gynecology.

[28]  Jianli Wu,et al.  No SARS-CoV-2 detected in amniotic fluid in mid-pregnancy , 2020, The Lancet Infectious Diseases.

[29]  O. Merino,et al.  Characteristics and Prognosis of Patients With Inflammatory Bowel Disease During the SARS-CoV-2 Pandemic in the Basque Country (Spain) , 2020, Gastroenterology.

[30]  Joana Lyra,et al.  Cesarean Section in a Pregnant Woman with COVID-19: First Case in Portugal. , 2020, Acta medica portuguesa.

[31]  J. Qiao,et al.  Clinical Characteristics of Pregnant Women with Covid-19 in Wuhan, China , 2020, The New England journal of medicine.

[32]  Zhong Zhou,et al.  Prevention of COVID-19 in patients with inflammatory bowel disease in Wuhan, China , 2020, The Lancet Gastroenterology & Hepatology.

[33]  M. Neurath.  COVID-19 and immunomodulation in IBD , 2020, Gut.

[34]  Dena Goffman,et al.  Universal Screening for SARS-CoV-2 in Women Admitted for Delivery , 2020, The New England journal of medicine.

[35]  D. Gommers,et al.  Incidence of thrombotic complications in critically ill ICU patients with COVID-19 , 2020, Thrombosis Research.

[36]  Feng Wang,et al.  Prevalence of venous thromboembolism in patients with severe novel coronavirus pneumonia , 2020, Journal of Thrombosis and Haemostasis.

[37]  Matthew Rowland,et al.  Trials of anti-tumour necrosis factor therapy for COVID-19 are urgently needed , 2020, The Lancet.

[38]  Dena Goffman,et al.  Coronavirus disease 2019 infection among asymptomatic and symptomatic pregnant women: two weeks of confirmed presentations to an affiliated pair of New York City hospitals , 2020, American Journal of Obstetrics & Gynecology MFM.

[39]  B. Yang,et al.  Novel coronavirus infection in newborn babies aged <28 days in China , 2020, European Respiratory Journal.

[40]  C. Eastin,et al.  Clinical Characteristics of Coronavirus Disease 2019 in China , 2020, The Journal of Emergency Medicine.

[41]  A. Amato,et al.  Outcomes of COVID-19 in 79 patients with IBD in Italy: an IG-IBD study , 2020, Gut.

[42]  H. Sokol,et al.  Increased incidence of systemic serious viral infections in patients with inflammatory bowel disease associates with active disease and use of thiopurines , 2020, United European gastroenterology journal.

[43]  Dengju Li,et al.  Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy , 2020, Journal of Thrombosis and Haemostasis.

[44]  Wei Zhang,et al.  Antibodies in Infants Born to Mothers With COVID-19 Pneumonia. , 2020, JAMA.

[45]  Jian Wang,et al.  Possible Vertical Transmission of SARS-CoV-2 From an Infected Mother to Her Newborn. , 2020, JAMA.

[46]  S. Ardizzone,et al.  Are Patients with Inflammatory Bowel Disease at Increased Risk for Covid-19 Infection? , 2020, Journal of Crohn's & colitis.

[47]  A. Wells,et al.  The role of CT in case ascertainment and management of COVID-19 pneumonia in the UK: insights from high-incidence regions , 2020, The Lancet Respiratory Medicine.

[48]  Dylan H. Morris,et al.  Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1 , 2020, The New England journal of medicine.

[49]  Xin Zhou,et al.  Risk Factors Associated With Acute Respiratory Distress Syndrome and Death in Patients With Coronavirus Disease 2019 Pneumonia in Wuhan, China , 2020, The Journal of Emergency Medicine.

[50]  Ling Feng,et al.  A case report of neonatal COVID-19 infection in China , 2020, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[51]  Ling Feng,et al.  A case report of neonatal COVID-19 infection in China , 2020, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[52]  A. M. Leontovich,et al.  The species Severe acute respiratory syndrome-related coronavirus: classifying 2019-nCoV and naming it SARS-CoV-2 , 2020, Nature Microbiology.

[53]  K. Yuen,et al.  Clinical Characteristics of Coronavirus Disease 2019 in China , 2020, The New England journal of medicine.

[54]  Xinghua Shen,et al.  A case of 2019 Novel Coronavirus in a pregnant woman with preterm delivery , 2020, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[55]  Q. Tao,et al.  Correlation of Chest CT and RT-PCR Testing in Coronavirus Disease 2019 (COVID-19) in China: A Report of 1014 Cases , 2020, Radiology.

[56]  Chuan Qin,et al.  Dysregulation of immune response in patients with COVID-19 in Wuhan, China , 2020, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[57]  Yuqiong Yang,et al.  Therapeutic and triage strategies for 2019 novel coronavirus disease in fever clinics , 2020, The Lancet Respiratory Medicine.

[58]  Huixia Yang,et al.  Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records , 2020, The Lancet.

[59]  Yan Zhao,et al.  Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. , 2020, JAMA.

[60]  Wenhao Zhou,et al.  Clinical analysis of 10 neonates born to mothers with 2019-nCoV pneumonia. , 2020, Translational pediatrics.

[61]  Eun Soo Kim,et al.  JAK Inhibitors Safety in Ulcerative Colitis: Practical Implications , 2020, Journal of Crohn's & colitis.

[62]  Ting Yu,et al.  Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study , 2020, The Lancet.

[63]  Jing Zhao,et al.  Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus–Infected Pneumonia , 2020, The New England journal of medicine.

[64]  G. Gao,et al.  A Novel Coronavirus from Patients with Pneumonia in China, 2019 , 2020, The New England journal of medicine.

[65]  S. Vermeire,et al.  Pregnancy outcomes in inflammatory bowel disease patients treated with vedolizumab, anti‐TNF or conventional therapy: results of the European CONCEIVE study , 2020, Alimentary pharmacology & therapeutics.

[66]  A. Shitrit,et al.  Assessment of the procoagulant potential and associated risk factors in pregnant patients with inflammatory bowel diseases. , 2019, European journal of internal medicine.

[67]  M. Coates,et al.  Increased Risk of Influenza and Influenza-Related Complications Among 140,480 Patients With Inflammatory Bowel Disease. , 2018, Inflammatory bowel diseases.

[68]  Z. Memish,et al.  Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infection during pregnancy: Report of two cases & review of the literature , 2018, Journal of Microbiology, Immunology and Infection.

[69]  European Crohn’s and Colitis Organisation , 2019, The Grants Register 2022.

[70]  T. Aittokallio,et al.  Novel activities of safe-in-human broad-spectrum antiviral agents , 2018, Antiviral Research.

[71]  A. Amiot,et al.  Long‐term efficacy and safety of ustekinumab in 122 refractory Crohn's disease patients: a multicentre experience , 2018, Alimentary pharmacology & therapeutics.

[72]  T. Ahmad,et al.  Exclusive enteral nutrition provides an effective bridge to safer interval elective surgery for adults with Crohn's disease , 2017, Alimentary pharmacology & therapeutics.

[73]  M. Loeb,et al.  Pregnancy as a risk factor for severe outcomes from influenza virus infection: A systematic review and meta-analysis of observational studies , 2017, Vaccine.

[74]  A. Assiri,et al.  Middle East Respiratory Syndrome Coronavirus Infection During Pregnancy: A Report of 5 Cases From Saudi Arabia , 2016, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[75]  I. Petersen,et al.  Common Infections in Patients Prescribed Systemic Glucocorticoids in Primary Care: A Population-Based Cohort Study , 2016, PLoS medicine.

[76]  H. Tilg,et al.  The First European Evidence-based Consensus on Extra-intestinal Manifestations in Inflammatory Bowel Disease. , 2016, Journal of Crohn's & colitis.

[77]  C. J. van der Woude,et al.  Tailored anti-TNF therapy during pregnancy in patients with IBD: maternal and fetal safety , 2015, Gut.

[78]  C. J. van der Woude,et al.  The second European evidenced-based consensus on reproduction and pregnancy in inflammatory bowel disease. , 2015, Journal of Crohn's & colitis.

[79]  L. Dauchet,et al.  Thromboembolic events and cardiovascular mortality in inflammatory bowel diseases: a meta-analysis of observational studies. , 2014, Journal of Crohn's & colitis.

[80]  S. Chimenti,et al.  Prevalence of Past and Reactivated Viral Infections and Efficacy of Cyclosporine A as Monotherapy or in Combination in Patients with Psoriatic Arthritis—Synergy Study: A Longitudinal Observational Study , 2014, BioMed research international.

[81]  A. Griffiths,et al.  Consensus statements on the risk, prevention, and treatment of venous thromboembolism in inflammatory bowel disease: Canadian Association of Gastroenterology. , 2014, Gastroenterology.

[82]  H. Yuhara,et al.  Meta‐analysis: the risk of venous thromboembolism in patients with inflammatory bowel disease , 2013, Alimentary pharmacology & therapeutics.

[83]  Mamoru Watanabe,et al.  A prospective analysis of the incidence of and risk factors for opportunistic infections in patients with inflammatory bowel disease , 2013, Journal of Gastroenterology.

[84]  S. Finlayson,et al.  Venous Thromboembolism After Surgery for Inflammatory Bowel Disease: Are There Modifiable Risk Factors? Data from ACS NSQIP , 2012, Diseases of the colon and rectum.

[85]  Ann-Beth Moller,et al.  National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: a systematic analysis and implications , 2012, The Lancet.

[86]  M. Hod,et al.  Inflammatory bowel disease: risk factors for adverse pregnancy outcome and the impact of maternal weight gain , 2012, The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians.

[87]  F. Granath,et al.  Congenital abnormalities and other birth outcomes in children born to women with ulcerative colitis in Denmark and Sweden , 2011, Inflammatory bowel diseases.

[88]  K. Farkas,et al.  Pregnancy outcome in patients with inflammatory bowel disease according to the activity of the disease and the medical treatment: A case–control study , 2010, Scandinavian journal of gastroenterology.

[89]  H. Sørensen,et al.  Crohn's disease is a risk factor for preterm birth. , 2010, Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association.

[90]  Herng‐Ching Lin,et al.  Ulcerative Colitis and Pregnancy Outcomes in an Asian Population , 2010, The American Journal of Gastroenterology.

[91]  G. Nguyen,et al.  Outcomes of obstetric hospitalizations among women with inflammatory bowel disease in the United States. , 2009, Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association.

[92]  F. Rosendaal,et al.  Pregnancy, the postpartum period and prothrombotic defects: risk of venous thrombosis in the MEGA study , 2008, Journal of thrombosis and haemostasis : JTH.

[93]  D. Corley,et al.  Pregnancy outcomes in women with inflammatory bowel disease: a large community-based study from Northern California. , 2007, Gastroenterology.

[94]  S. Rasmussen,et al.  Emerging Infections and Pregnancy , 2006, Emerging infectious diseases.

[95]  T. Ng,et al.  Pregnancy and perinatal outcomes of women with severe acute respiratory syndrome , 2004, American Journal of Obstetrics and Gynecology.

[96]  T. Leung,et al.  A case‐controlled study comparing clinical course and outcomes of pregnant and non‐pregnant women with severe acute respiratory syndrome , 2004, BJOG : an international journal of obstetrics and gynaecology.

[97]  S. Patel,et al.  Perinatal outcomes in inflammatory bowel disease , 2004, The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians.