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

Uma Mahadevan¹, Cynthia H Seow², Edward L Barnes³, María Chaparro⁴, Emma Flanagan⁵, Sonia Friedman⁶, Mette Julsgaard^{7

8}, Sunanda Kane⁹, Siew Ng^{10

11

12}, Joana Torres¹³, Gillian Watermeyer¹⁴, Jesus Yamamoto-Furusho¹⁵, Christopher Robinson¹⁶, Susan Fisher¹⁷, Phil Anderson¹⁸, Richard Gearry¹⁹, Dana Duricova²⁰, Marla Dubinsky²¹, 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, Australia, Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia.
⁶ Division of Gastroenterology and Hepatology, Tufts Medical Center, Boston, Massachusetts, USA.
⁷ Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark.
⁸ Institute of Clinical Medicine, Health, Aarhus University, Aarhus, Denmark.
⁹ Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA.
¹⁰ Microbiota I-Center (MagIC), Hong Kong, SAR, China.
¹¹ Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, SAR, China.
¹² 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.
¹³ Division of Gastroenterology, Hospital da luz Lisbon, Division of Gastroenterology, Hospital Beatriz Ângelo, Portugal Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.
¹⁴ Department of Medicine University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa.
¹⁵ Inflammatory Bowel Disease Clinic, Department of Gastroenterology, National Institute of Medical Sciences and Nutrition Salvador Zubiran, Mexico City, Mexico.
¹⁶ Charleston Maternal Fetal Medicine, East Cooper Medical Center, Mount Pleasant, South Carolina, USA.
¹⁷ Department of Obstetrics and Gynecology, University of California, San Francisco, California, USA.
¹⁸ Skaggs School of Pharmacy and Pharmaceutical Sciences, San Diego, California, USA.
¹⁹ Department of Medicine, University of Otago, Christchurch, New Zealand.
²⁰ Clinical and Research Center for IBD, ISCARE a.s., Prague, Czech Republic.
²¹ Division of Pediatric Gastroenterology, Susan and Leonard Feinstein IBD Clinical Center, Icahn School of Medicine, New York, New York, USA.

PMID: 40874657
DOI: 10.1111/apt.70290

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

Uma Mahadevan et al. Aliment Pharmacol Ther. 2025 Dec.

. 2025 Dec;62(11-12):1125-1180.

doi: 10.1111/apt.70290. Epub 2025 Aug 28.

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, Australia, Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia.
⁶ Division of Gastroenterology and Hepatology, Tufts Medical Center, Boston, Massachusetts, USA.
⁷ Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark.
⁸ Institute of Clinical Medicine, Health, Aarhus University, Aarhus, Denmark.
⁹ Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA.
¹⁰ Microbiota I-Center (MagIC), Hong Kong, SAR, China.
¹¹ Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, SAR, China.
¹² 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.
¹³ Division of Gastroenterology, Hospital da luz Lisbon, Division of Gastroenterology, Hospital Beatriz Ângelo, Portugal Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.
¹⁴ Department of Medicine University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa.
¹⁵ Inflammatory Bowel Disease Clinic, Department of Gastroenterology, National Institute of Medical Sciences and Nutrition Salvador Zubiran, Mexico City, Mexico.
¹⁶ Charleston Maternal Fetal Medicine, East Cooper Medical Center, Mount Pleasant, South Carolina, USA.
¹⁷ Department of Obstetrics and Gynecology, University of California, San Francisco, California, USA.
¹⁸ Skaggs School of Pharmacy and Pharmaceutical Sciences, San Diego, California, USA.
¹⁹ Department of Medicine, University of Otago, Christchurch, New Zealand.
²⁰ Clinical and Research Center for IBD, ISCARE a.s., Prague, Czech Republic.
²¹ Division of Pediatric Gastroenterology, Susan and Leonard Feinstein IBD Clinical Center, Icahn School of Medicine, New York, New York, USA.

PMID: 40874657
DOI: 10.1111/apt.70290

Abstract

Background & aims: 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 (Grading of Recommendations Assessment, Development, and Evaluation) 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 ten categories with 34 GRADE recommendations and 35 consensus statements.

Conclusions: 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: Crohn’s disease; JAK inhibitors; biologics; inflammatory bowel disease; pregnancy; ulcerative colitis.

© 2025 The American Gastroenterological Association, British Society of Gastroenterology, The American College of Gastroenterology, European Crohn’s and Colitis Organisation, John Wiley & Sons Limited and Crohn’s and Colitis Foundation. Published by Elsevier Inc on behalf of The American Gastroenterological Association, by BMJ Publishing Group Ltd on behalf of British Society of Gastroenterology, by Wolters Kluwer Health, Inc. on behalf of The American College 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. U. Mahadevan, M. D. Long, S. V. Kane, et al., “Pregnancy and Neonatal Outcomes After Fetal Exposure to Biologics and Thiopurines Among Women With Inflammatory Bowel Disease,” Gastroenterology 160 (2021): 1131–1139.
1. C. P. Selinger, J. Eaden, W. Selby, et al., “Patients' Knowledge of Pregnancy‐Related Issues in Inflammatory Bowel Disease and Validation of a Novel Assessment Tool (‘CCPKnow’),” Alimentary Pharmacology & Therapeutics 36 (2012): 57–63.
1. R. T. Sutton, K. Wierstra, J. Bal, et al., “Pregnancy‐Related Beliefs and Concerns of Inflammatory Bowel Disease Patients Modified After Accessing e‐Health Portal,” J Can Assoc Gastroenterol 4 (2021): 27–35.
1. S. R. Marri, C. Ahn, and A. L. Buchman, “Voluntary Childlessness Is Increased in Women With Inflammatory Bowel Disease,” Inflammatory Bowel Diseases 13 (2007): 591–599.

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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

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Medical