Successful pregnancy in a patient with active Crohn's disease, chronic intestinal failure, and long‐term parenteral nutrition receiving upadacitinib: A case report
Bibliographic record
Abstract
Data on pregnancy in patients with Crohn's disease receiving Janus kinase (JAK) inhibitors, with concomitant short bowel syndrome and chronic intestinal failure requiring long-term parenteral support, are extremely limited. We report the case of a patient with refractory Crohn's disease, short bowel syndrome-associated chronic intestinal failure, and long-term home parenteral nutrition who achieved a successful full-term pregnancy while receiving upadacitinib. The 34-year-old woman had a history of severe, treatment-resistant ileocolonic Crohn's disease and multiple intestinal resections, leaving 145 cm of small bowel and resulting in high-output stoma and chronic intestinal failure. After inadequate response to multiple biologics, upadacitinib was initiated with clinical and endoscopic improvement. The patient became pregnant unintentionally while receiving upadacitinib 45 mg daily. Through intensive multidisciplinary management, she achieved clinical remission, stable parenteral support needs, and adequate weight gain and delivered a healthy infant at term. This case illustrates that with close multidisciplinary follow-up, successful pregnancy is possible in patients with chronic intestinal failure and active Crohn's disease receiving parenteral support, even with concurrent exposure to upadacitinib. Further data are needed to assess the safety of JAK inhibitors in pregnancy and to guide care in this complex patient population.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.005 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.004 | 0.003 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".