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Review
. 2020 May 19;12(3):214-224.
doi: 10.1136/flgastro-2019-101371. eCollection 2021.

IBD in pregnancy: recent advances, practical management

Christian P Selinger  1 , Catherine Nelson-Piercy  2 , Aileen Fraser  3 , Veronica Hall  4 , Jimmy Limdi  5   6 , Lyn Smith  7 , Marie Smith  8 , Reem Nasur  8 , Melanie Gunn  9 , Andrew King  9 , Aarthi Mohan  10 , Khasia Mulgabal  11 , Alexandra Kent  12 , Klaartje Bel Kok  13 , Tracey Glanville  14
Affiliations
Review

IBD in pregnancy: recent advances, practical management

Christian P Selinger et al. Frontline Gastroenterol. .

Abstract

Inflammatory bowel disease (IBD) poses complex issues in pregnancy, but with high-quality care excellent pregnancy outcomes are achievable. In this article, we review the current evidence and recommendations for pregnant women with IBD and aim to provide guidance for clinicians involved in their care. Many women with IBD have poor knowledge about pregnancy-related issues and a substantial minority remains voluntarily childless. Active IBD is associated with an increased risk of preterm birth, low for gestation weight and fetal loss. With the exception of methotrexate and tofacitinib the risk of a flare outweighs the risk of IBD medication and maintenance of remission from IBD should be the main of care. Most women with IBD will experience a normal pregnancy and can have a vaginal delivery. Active perianal Crohn's disease is an absolute and ileal pouch surgery a relative indication for a caesarean section. Breast feeding is beneficial to the infant and the risk from most IBD medications is negligible.

Keywords: crohn's disease; ulcerative colitis.

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Conflict of interest statement

Competing interests: CPS has received unrestricted research grants from Warner Chilcott, Janssen and AbbVie, has provided consultancy to Warner Chilcott, Falk, AbbVie, Takeda, Fresenius Kabi and Janssen, and had speaker arrangements with Warner Chilcott, Falk, AbbVie, MSD, Pfizer and Takeda. CN-P had speaker arrangements with Falk, UCB, Sanofi, Alliance and Alexion. KBK has provided consultancy to Amgen and PredictImmune, and had speaker arrangements with Janssen and Takeda. JL has received research grants from Takeda, consultancy and speaker fees from Abbvie, Janssen, MSD, Pfizer and Takeda. AK has provided consultancy to Abbvie, and had speaker arrangements with Pfizer, Janssen and Takeda.

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