IBD Pro | Key Takeaways from Global Pregnancy Guidelines

For the first time, an international panel of IBD experts, maternal-fetal medicine specialists, surgeons, and patient advocates recently came together to establish global consensus guidelines for pregnancy in inflammatory bowel disease (IBD). Published simultaneously in six leading journals—including Inflammatory Bowel Diseases, the official journal of the Crohn’s & Colitis Foundation and a core IBD Pro Member benefit—these recommendations provide a much-needed blueprint for evidence-based care from preconception through postpartum.

Why this matters for the IBD community

Pregnancy can be a time of uncertainty for patients. Clinical trials exclude pregnant patients, leaving clinicians with limited data to guide therapy. Yet stopping treatment can lead to disease flares, which increase both maternal and fetal risks. These guidelines provide standardized, practical recommendations for providers across practice settings.

Key clinical takeaways

• Preconception: Women with IBD should receive counseling and ideally be in remission for 3–6 months before conception.
• High-risk designation: All pregnancies in women with IBD should be managed as high-risk.
• Medication use: Continue 5-ASAs, thiopurines, and all biologics throughout conception, pregnancy, and lactation. Small molecules should generally be avoided unless essential.
• Biologics & breastfeeding: Despite placental transfer, biologics detected in breast milk are minimal and not linked to adverse infant outcomes. Breastfeeding is encouraged.
• Preventive care: Begin low-dose aspirin by 12–16 weeks to reduce preeclampsia risk; monitor for venous thromboembolism throughout pregnancy and postpartum.
• Vaccination: Infants exposed to biologics in utero should still receive rotavirus vaccination on schedule.

Read the full consensus in IBD Journal.