Inflammatory Bowel Disease (IBD) are chronic conditions commonly presenting in the reproductive years with up to 620000 people affected in the UK. Numerous specialist studies and reviews looking at IBD and fertility, IBD medications during pregnancy and breastfeeding, pregnancy outcome in IBD patients exist, but there is no summarising review for clinicians or patients, thus women may not receive consistent advice.Objective
Design and present a management algorithm for clinicians and information leaflet for women with IBD consistent with current literature and available guidelines.Method
Using the European Crohn’s Colitis Organisation’s (ECCO) guideline on reproduction in inflammatory bowel disease as the baseline, relevant NICE guidelines and other systematic reviews and meta-analyses on the subject of inflammatory bowel disease and reproduction were consulted and reviewed.Results
Current literature and available guidelines support the consensus that disease remission is the best prognostic indicator of optimal outcome for both mother and baby. Systematic reviews have also highlighted the safety of all commonly used immunosuppressant drugs, with the exception of methotrexate and mycophenolate mofetil.Conclusion
Patients with IBD can have pregnancies comparable to the wider population with normal outcomes. Consistent advice from clinicians and informing IBD patients that they should continue their medications both during breastfeeding may improve compliance and empower the women to get specialist referral where necessary.