Inflammatory Bowel Disease in Pregnancy

  • Sunanda Kane


Inflammatory bowel disease (IBD) occurs in women during their childbearing years. There is a lot of concern on the part of patients in regards to the effect of IBD on a pregnancy as well as the potential effects of pregnancy on disease activity. Understanding the risks of certain medications and the potential outcomes in women with IBD is important for appropriate counseling. Overall, fertility in IBD patients is not impaired, with the exception of women status post an ileal pouch anal anastomosis (IPAA) procedure for ulcerative colitis or active colonic disease in women with Crohn’s. Consistent outcomes in pregnancies in women with IBD include small for gestational age, low birth weight, and preterm. However, there is no data to suggest that there is any increased risk for congenital abnormalities. Medications used to treat IBD for the most part are low risk during pregnancy, as uncontrolled inflammation is thought to be more detrimental to a pregnancy than medical therapy. Mesalamine has been demonstrated as safe in any form. Controversial is the use of thiopurines due to their category D rating; however, population-based studies have failed to identify any increased risk for birth defects in children born to women or men on these agents. Biologics cross the placenta starting around week 20 and levels have been detected in cord blood and neonates. C-sections appear to be performed more frequently in women with IBD but apparently more from fear of the obstetrician than medical reasons. The most important management point is that active inflammation is detrimental to a pregnancy and that it needs to be controlled via whatever means necessary to ensure a successful pregnancy.


Inflammatory Bowel Disease Ulcerative Colitis Spontaneous Abortion Inflammatory Bowel Disease Patient Crohn Disease 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Department of MedicineMayo ClinicRochesterUSA

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