Global Consensus Statement on the Management of Pregnancy in Inflammatory Bowel Disease

Uma Mahadevan¹, Cynthia H Seow², Edward L Barnes³, María Chaparro⁴, Emma Flanagan^{5

6}, Sonia Friedman⁷, Mette Julsgaard^{8

9}, Sunanda Kane¹⁰, Siew Ng^{11

12

13}, Joana Torres^{14

15

16}, Gillian Watermeyer¹⁷, Jesus Yamamoto-Furusho¹⁸, Christopher Robinson¹⁹, Susan Fisher²⁰, Phil Anderson²¹, Richard Gearry²², Dana Ďuricová²³, Marla Dubinsky²⁴, Millie Long³; Global Consensus Group for Pregnancy and IBD

Collaborators, Affiliations

Collaborators

Global Consensus Group for Pregnancy and IBD:
Maria Abreu, Nahla Ali Azzam, Wafaa Badre, Rupa Banerjee, Sally Bell, Susan Connor, Iris Dotan, Marc Ferrante, Emily Finlayson, Ryota Hokari, Vivian Huang, Patricio Ibanez, Fabian Juliao, Leolin Katsidzira, Alicia Sambuelli, Christian Selinger, Shu-Chen Wei, Astrid Williams, Cyrla Zaltman, Jessica Lim, Nicole Arima, Wenli Chen, Natalie Hayden, Heng Chun Lin, Anne Brosbol Ravnborg, Treza Njeri Mwaura-Ruhio, Lindsay Rous

Affiliations

¹ Division of Gastroenterology, Department of Medicine, University of California, San Francisco, California, USA.
² Inflammatory Bowel Disease Unit, Division of Gastroenterology and Hepatology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
³ Division of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
⁴ Gastroenterology Department, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Universidad Autónoma de Madrid (UAM), and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain.
⁵ Department of Gastroenterology, St Vincent's Hospital Melbourne, Melbourne, Australia.
⁶ Department of Medicine, University of Melbourne, Melbourne, Australia.
⁷ Division of Gastroenterology and Hepatology, Tufts Medical Center, Boston, Massachusetts, USA.
⁸ Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark.
⁹ Institute of Clinical Medicine, Health, Aarhus University, Aarhus, Denmark.
¹⁰ Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA.
¹¹ Microbiota I-Center (MagIC), Hong Kong SAR, China.
¹² Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, SAR, China.
¹³ Li Ka Shing Institute of Health Sciences, State Key Laboratory of Digestive Disease Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong SAR, China.
¹⁴ Division of Gastroenterology, Hospital da Luz Lisbon, Lisbon, Portugal.
¹⁵ Division of Gastroenterology, Hospital Beatriz Ângelo, Loures, Portugal.
¹⁶ Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.
¹⁷ Department of Medicine, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa.
¹⁸ Inflammatory Bowel Disease Clinic, Department of Gastroenterology, National Institute of Medical Sciences and Nutrition Salvador Zubiran, Mexico City, Mexico.
¹⁹ Charleston Maternal Fetal Medicine, East Cooper Medical Center, Mount Pleasant, South Carolina, USA.
²⁰ Department of Obstetrics and Gynecology, University of California, San Francisco, California, USA.
²¹ Skaggs School of Pharmacy and Pharmaceutical Sciences, San Diego, California, USA.
²² Department of Medicine, University of Otago, Christchurch, New Zealand.
²³ Clinical and Research Center for IBD, ISCARE a.s., Prague, Czech Republic.
²⁴ Division of Pediatric Gastroenterology, Susan and Leonard Feinstein IBD Clinical Center, Icahn School of Medicine, Mount Sinai, New York, New York, USA .

PMID: 40862489
DOI: 10.14309/ajg.0000000000003651

Global Consensus Statement on the Management of Pregnancy in Inflammatory Bowel Disease

Uma Mahadevan et al. Am J Gastroenterol. 2025.

. 2025 Aug 27.

doi: 10.14309/ajg.0000000000003651. Online ahead of print.

Authors

Collaborators

Global Consensus Group for Pregnancy and IBD:
Maria Abreu, Nahla Ali Azzam, Wafaa Badre, Rupa Banerjee, Sally Bell, Susan Connor, Iris Dotan, Marc Ferrante, Emily Finlayson, Ryota Hokari, Vivian Huang, Patricio Ibanez, Fabian Juliao, Leolin Katsidzira, Alicia Sambuelli, Christian Selinger, Shu-Chen Wei, Astrid Williams, Cyrla Zaltman, Jessica Lim, Nicole Arima, Wenli Chen, Natalie Hayden, Heng Chun Lin, Anne Brosbol Ravnborg, Treza Njeri Mwaura-Ruhio, Lindsay Rous

Affiliations

¹ Division of Gastroenterology, Department of Medicine, University of California, San Francisco, California, USA.
² Inflammatory Bowel Disease Unit, Division of Gastroenterology and Hepatology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
³ Division of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
⁴ Gastroenterology Department, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Universidad Autónoma de Madrid (UAM), and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain.
⁵ Department of Gastroenterology, St Vincent's Hospital Melbourne, Melbourne, Australia.
⁶ Department of Medicine, University of Melbourne, Melbourne, Australia.
⁷ Division of Gastroenterology and Hepatology, Tufts Medical Center, Boston, Massachusetts, USA.
⁸ Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark.
⁹ Institute of Clinical Medicine, Health, Aarhus University, Aarhus, Denmark.
¹⁰ Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA.
¹¹ Microbiota I-Center (MagIC), Hong Kong SAR, China.
¹² Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, SAR, China.
¹³ Li Ka Shing Institute of Health Sciences, State Key Laboratory of Digestive Disease Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong SAR, China.
¹⁴ Division of Gastroenterology, Hospital da Luz Lisbon, Lisbon, Portugal.
¹⁵ Division of Gastroenterology, Hospital Beatriz Ângelo, Loures, Portugal.
¹⁶ Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.
¹⁷ Department of Medicine, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa.
¹⁸ Inflammatory Bowel Disease Clinic, Department of Gastroenterology, National Institute of Medical Sciences and Nutrition Salvador Zubiran, Mexico City, Mexico.
¹⁹ Charleston Maternal Fetal Medicine, East Cooper Medical Center, Mount Pleasant, South Carolina, USA.
²⁰ Department of Obstetrics and Gynecology, University of California, San Francisco, California, USA.
²¹ Skaggs School of Pharmacy and Pharmaceutical Sciences, San Diego, California, USA.
²² Department of Medicine, University of Otago, Christchurch, New Zealand.
²³ Clinical and Research Center for IBD, ISCARE a.s., Prague, Czech Republic.
²⁴ Division of Pediatric Gastroenterology, Susan and Leonard Feinstein IBD Clinical Center, Icahn School of Medicine, Mount Sinai, New York, New York, USA .

PMID: 40862489
DOI: 10.14309/ajg.0000000000003651

Abstract

Introduction: Pregnancy can be a complex and risk filled event for women with inflammatory bowel disease (IBD). High-quality studies in this population are lacking, with limited data on medications approved to treat IBD during pregnancy. For patients, limited knowledge surrounding pregnancy impacts pregnancy rates, medication adherence, and outcomes. Limited provider knowledge leads to highly varied practices in care affected by local dogma, available resources, individual interpretation of the literature, and fear of harming the fetus. The variations in guidelines by different societies and countries reflect this and lead to confusion for physicians and patients alike. The Global Consensus Consortium is a group of 39 IBD and content experts and 7 patient advocates from 6 continents who convened to review and assess current data and come to an agreement on best practices based on these data.

Methods: The GRADE process was used when sufficient published data were available and the RAND process in those instances where expert opinion was needed to guide consistent practice. Recommendations were informed by the guiding principle that maternal health best supports infant health.

Results: The topics were divided into 10 categories with 34 GRADE recommendations and 35 Consensus statements.

Discussion: Overall, the goal of the group was to provide data-driven and practical guidance to improve the care of women with IBD around the globe based on the best available research.

Keywords: Biologics; Crohn's disease; JAK inhibitors; inflammatory bowel disease; pregnancy; ulcerative colitis.

Copyright © 2025 The American College of Gastroenterology, the American Gastroenterological Association, British Society of Gastroenterology, European Crohn's and Colitis Organisation, John Wiley & Sons Limited and Crohn's and Colitis Foundation. Published by Wolters Kluwer Health, Inc. on behalf of The American College of Gastroenterology, by Elsevier Inc on behalf of The American Gastroenterological Association, by BMJ Publishing Group Ltd on behalf of British Society of Gastroenterology, by Oxford University Press on behalf of European Crohn's and Colitis Organisation, by John Wiley & Sons Limited and by Oxford University Press on behalf of Crohn's and Colitis Foundation. All rights are reserved, including those for text and data mining, AI training, and similar technologies.

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References

1. United States Food and Drug Administration. Final Rule on the Content and Formation of a New Drug Application 1998;(21 CFR §314.50 (d)(5)).
1. Mahadevan U, Long MD, Kane SV, Crohn's Colitis Foundation Clinical Research Alliance, , et al. Pregnancy and neonatal outcomes after fetal exposure to biologics and thiopurines among women with inflammatory bowel disease. Gastroenterology 2021;160:1131–9.
1. Selinger CP, Eaden J, Selby W, et al. Patients' knowledge of pregnancy-related issues in inflammatory bowel disease and validation of a novel assessment tool (‘CCPKnow’). Aliment Pharmacol Ther 2012;36:57–63.
1. Sutton RT, Wierstra K, Bal J, et al. Pregnancy-related beliefs and concerns of inflammatory bowel disease patients modified after accessing e-health portal. J Can Assoc Gastroenterol 2021;4:27–35.
1. Marri SR, Ahn C, Buchman AL. Voluntary childlessness is increased in women with inflammatory bowel disease. Inflamm Bowel Dis 2007;13:591–9.

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Global Consensus Statement on the Management of Pregnancy in Inflammatory Bowel Disease

Collaborators

Affiliations

Global Consensus Statement on the Management of Pregnancy in Inflammatory Bowel Disease

Authors

Collaborators

Affiliations

Abstract

References

LinkOut - more resources

Full Text Sources