Observational studyDigestive diseases and sciences2021
Non-adherence to Medications in Pregnant Ulcerative Colitis Patients Contributes to Disease Flares and Adverse Pregnancy Outcomes.
Observational study in Digestive diseases and sciences, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 35 citations in OpenAlex.
- Quality of healthcare delivery in inflammatory bowel disease pregnancy: a scoping review.Inflammatory bowel diseases · 2026Article
- Article
- What the Patient Thinks and What the Patient Does: Placebo, Nocebo, and Therapy Adherence in Ulcerative Colitis.Journal of clinical medicine · 2025Review
- Ulcerative Colitis in Pregnancy: A Japanese Multicenter Cohort Study Focusing on Their Mutual Influence.Internal medicine (Tokyo, Japan) · 2025Article
- Medication Non-Adherence in Inflammatory Bowel Disease: A Systematic Review Identifying Risk Factors and Opportunities for Intervention.Pharmacy (Basel, Switzerland) · 2025Review
- Communicating medication risks in pregnancy: Towards shared decision making.Frontiers in drug safety and regulation · 2025Article
- IBD and Motherhood: A Journey through Conception, Pregnancy and Beyond.Journal of clinical medicine · 2023Review
- Rectovaginal Fistula From Untreated Ulcerative Colitis in Pregnancy: A Case Report and Review of the Literature.Cureus · 2023Article
- Planning to conceive within a year is associated with better pregnancy-specific disease-related patient knowledge and better medication adherence in women of childbearing age with inflammatory bowel disease.Therapeutic advances in gastroenterology · 2023Article
- Risk of Adverse Pregnancy Outcomes for Women with IBD in an Expert IBD Antenatal Clinic.Journal of clinical medicine · 2022Article
- Medication Adherence During Pregnancy in IBD: Compliance Avoids Complications.Digestive diseases and sciences · 2021Article
- Provision of care for pregnant women with IBD in the UK: the current landscape.Frontline gastroenterology · 2021Article
- Patient Preference and Adherence to Aminosalicylates for the Treatment of Ulcerative Colitis.Clinical and experimental gastroenterology · 2021Review
- Review of pregnancy in Crohn's disease and ulcerative colitis.Therapeutic advances in gastroenterology · 2021Review
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Authors and funding
21 authors at 17 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAdherence to medications is important to maintain disease under control and to prevent complications in pregnant patients with ulcerative colitis (UC). To evaluate the incidence of non-adherence during pregnancy and its effect on relapse and pregnancy outcomes, we conducted a multicenter prospective study using a patient self-reporting system without physician interference.
methodsSixty-eight pregnant UC women were recruited from 17 institutions between 2013 and 2019. During the course of pregnancy, questionnaires were collected separately from patients and physicians, to investigate the true adherence to medications, disease activity, and birth outcomes. Multivariable logistic regression analysis was performed to identify the risk factors for the relapse or adverse pregnancy outcomes.
resultsOf 68 pregnancy, 15 adverse pregnancy outcomes occurred in 13 patients. The rate of self-reported non-adherence was the greatest to mesalamines in the first trimester, which was significantly higher than physicians' estimate (p = 0.0116), and discontinuation was observed in 42.1% of non-adherent group. Logistic regression analysis revealed non-adherence as an independent risk factor for relapse [odds ratio (OR) 7.659, 95% CI 1.928-30.427, p = 0.038], and possibly for adverse pregnancy outcome (OR 8.378, 95% CI 1.350-51.994, p = 0.023). Among the subgroup of patients treated with oral mesalamine alone, the non-adherence was confirmed to be an independent risk factor for relapse (p = 0.002).
conclusionNon-adherence to mesalamine was underestimated by physicians in pregnant UC patients and contributed to disease relapse and possibly on pregnancy outcomes. Preconceptional education regarding safety of medications and risk of self-discontinuation is warranted.
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