The impact of disease activity of Crohn’s disease during pregnancy on fetal growth

Although it is known that women with inflammatory bowel disease have an increased risk of adverse outcome of pregnancy, the relationship between disease activity during pregnancy and the adverse outcome is not well known. A 29-year-old woman with Crohn’s disease presented with flare-up at the end of the first trimester. Although the disease had been rendered inactive by maintenance infusion of infliximab, the drug was discontinued at the time of conception because of the patient’s fear of the adverse effects of infliximab. Because retardation of fetal growth was observed at the flare-up, we re-started infliximab therapy. As disease activity reduced with therapy, the retardation of fetal growth subsequently improved. The patient finally delivered a newborn of 2550 g in weight and no adverse outcome was noted. The case supports the notion that disease activity is a risk factor for adverse outcome in pregnancy and that infliximab may be safely used in pregnancy.