Inflammatory bowel disease in pregnancy: management strategy based on best evidence and European guidelines.

Abstract

#### Clinical Question What can the primary care practitioner offer men and women with inflammatory bowel disease who are contemplating starting a family? Inflammatory bowel disease (IBD) affects approximately 620 000 people in the UK. IBD (including both Crohn’s disease and ulcerative colitis) is a chronic condition commonly presenting in the teens and twenties.1 Thus it may affect individuals who are anxious about the impact of their medications or their disease on fertility, pregnancy, neonatal outcomes, and breastfeeding. For most patients, their GPs, specialist IBD nurses, or midwives are likely to be the first port of call to address such concerns. Several studies report that patients with IBD believe that their medications are contraindicated in pregnancy or at the very least cause some degree of harm to their unborn child despite evidence to the contrary.2 This article is aimed at primary care practitioners and is a concise summary of various specialist reviews and guidelines on the optimal management of IBD in pregnancy. Several studies have shown that women with IBD are just as likely to become pregnant as those without IBD,3 with two exceptions: women with active Crohn’s disease who may have reduced fertility and women who have had pelvic surgery. The effect of pelvic …