Physiological and psychological stress in pregnant women with quiescent inflammatory bowel disease: A pilot study using salivary biomarkers

Khil, Jennifer; Picardo, Sherman; Seow, Cynthia H.; Leung, Yvette; Metcalfe, Amy; Afshar, Elnaz Ehteshami; Sharifi, Nasibeh; Campbell, Tavis S.; Letourneau, Nicole; Dewey, Deborah; Giesbrecht, Gerald F.; Team, APrON Study

doi:10.1002/jgh3.12317

Cited by 4 publications

(6 citation statements)

References 36 publications

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“…Salivary cortisol and alpha-amylaseare novel biomarkers of stress tied to triggering of latent IBD, reflecting the hypothalamic-pituitary-adrenal axis and sympathetic nervous system, respectively. [ 278 ]…”

Section: Figurementioning

confidence: 99%

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Managing Pregnancy and Nursing Affecting African American Women with Inflammatory Bowel Disease: Clinical Outcomes and Parenthood

M’Koma¹,

Ware²,

Nabaweesi³

et al. 2023

MRAJ

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Inflammatory bowel disease (IBD) is a term for two autoimmune diseases encompassing Crohn’s disease (CD) and ulcerative colitis (UC) which are lifelong diseases affecting more than 3 million adults (1.3%) in the United States. IBD is characterized by chronic inflammation of the whole digestive system which results in damage to the gastrointestinal (GI) tract. IBD often emerges during adolescence and young adulthood. Maternal morbidity includes physical and psychological conditions that result from or are aggravated by pregnancy and have an adverse effect on a woman’s health, the baby’s health or both. Some women have health challenges that arise before or during pregnancy that could lead to complications. It is recommended for women to receive health care counseling before and during pregnancy. Compared to other developed countries, the United States has the highest rate of women dying of pregnancy related complications. During the past 25 years maternal mortality has been getting worse. African American women (AAW) with and/or without IBD are dying at significantly higher rates than other groups. This is linked to several factors, i.e., systemic, institutionalized, and structural racism in health-care delivery and subsequent toxic stress from people’s lived experiences of racism, limited knowledge about healthcare system function, lack of access to healthcare, (inclusiveness and insurance policies) all of which negatively impact these patients. African Americans (AAs) are also up to three times as likely to experience severe maternal morbidity: unexpected outcomes of labor and delivery, deficient or lacking prenatal care and social determinants of health like lack of transportation, adequate employment, limited literacy, and limited healthcare access contribute to poor health outcomes. Studies on IBD patients indicate Medicaid expansion is associated with reduced rates of maternal morbidity, particularly for African American Women (AAW) and increased access to preconception and prenatal services that make pregnancy and childbirth safer for parent and baby. Herein we examine the physiological changes of pregnancy in patients diagnosed with inflammatory bowel disease and their relationship perinatal outcomes and parenthood.

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Section: Figurementioning

confidence: 99%

“…The effect of chronic disease need to be evaluated in future studies by including a comparative group of pregnant women with active IBD. [ 278 ]…”

Section: Figurementioning

confidence: 99%

Managing Pregnancy and Nursing Affecting African American Women with Inflammatory Bowel Disease: Clinical Outcomes and Parenthood

M’Koma¹,

Ware²,

Nabaweesi³

et al. 2023

MRAJ

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“…Risk factors are maternal age and medical condition, delivery year, perinatal care, and infant mortality [53 ▪ ]. Pregnancy may be an additional stress factor for IBD patients but measurement of salivary cortisol and alpha-amylase, novel stress biomarkers show no difference between 13 pregnant women with quiescent disease and their matched for parity and gestational age controls [57].…”

Section: Psychological Wellbeingmentioning

confidence: 99%

The impact of inflammatory bowel disease on women's lives

Truta

2021

Current Opinion in Gastroenterology

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Purpose of reviewInflammatory bowel disease (IBD) affects women differently than men. This review outlines the current thinking on the impact of IBD, Crohn's disease and ulcerative colitis, on women's health.Recent findingsIBD symptoms worsen during the menstrual cycle without corelating to disease activity. Endometriosis is more frequent in women with than those without IBD. Low fertility rate is rather because of voluntary childlessness than severe disease, perianal involvement, and ileal pouch anal anastomosis (IPAA) surgery. For women with ulcerative colitis, in-vitro fertilization successfully overcomes the post-IPAA infertility. The use of biologics and thiopurines throughout pregnancy is well tolerated for both the mother and the child but the use of small molecule therapy still needs more data. These medications increase the risk of cervical cancer, anal cancer, and aggressive vulvar cancer. More screening efforts are required to keep patients healthy. Women with Crohn's disease report worse psychological well being less resilience than men but they develop more escape and avoidance strategies to cope with the disease. Depression impairs the quality of sexual life but sexual dysfunction is rarely discussed with the provider.SummaryUnderstanding the effects of sex on IBD allows personalized care and improves women's quality of life.

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“…Despite stress being associated with the course of IBD and increasing during the exacerbation of symptoms, contributing to the aggravation of the symptomatology in a study conducted on pregnant women with well-controlled IBD (six with CD and seven with UC), no changes in salivary cortisol were observed in comparison to healthy pregnant women [ 78 ]. The inverse relationship between vagal tone quantified by the power spectral analysis of the heart rate variability and evening salivary cortisol level is absent in patients with UC [ 79 ].…”

Section: Cortisolmentioning

confidence: 99%

Salivary Stress/Immunological Markers in Crohn’s Disease and Ulcerative Colitis

Finamore

Peluso

Cauli

2020

IJMS

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There is continuous and growing interest in research into new alternatives to standard biomarkers to detect and follow-up disease, reducing physical and psychological stress in patients needing regular and invasive medical examinations for the evaluation of pathologies, including inflammatory bowel diseases (IBD). Saliva is one of the most promising body fluids in the research of new biomarkers, thanks to the large number of molecules it contains. Many molecules present in saliva are often directly correlated to their concentration in the blood but may be affected by the condition of the oral cavity. This means that a careful selection of a specific biomarker is required for each pathology, especially pathologies such as IBD, which may induce inflammation in the oral cavity. Here, we analyze the currently used and the proposed new salivary biomarkers (i.e., calprotectin, cytokines, IgA, cortisol, and oxidative stress markers) for the detection and follow-up of the main subtypes of IBD, known as ulcerative colitis and Crohn’s disease.

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Physiological and psychological stress in pregnant women with quiescent inflammatory bowel disease: A pilot study using salivary biomarkers

Cited by 4 publications

References 36 publications

Managing Pregnancy and Nursing Affecting African American Women with Inflammatory Bowel Disease: Clinical Outcomes and Parenthood

Managing Pregnancy and Nursing Affecting African American Women with Inflammatory Bowel Disease: Clinical Outcomes and Parenthood

The impact of inflammatory bowel disease on women's lives

Salivary Stress/Immunological Markers in Crohn’s Disease and Ulcerative Colitis

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