Background

IBD onset typically occurs during the reproductive years. Therefore, women and their families often have concerns regarding how IBD and IBD medications affect their pregnancy and offspring. Many women with IBD who wish to have children are often on medications that may need to be adjusted. Zelinkova (2010) conducted a study on IBD patients with active plans for conception and found that a large proportion of patients are taking IBD medications, especially immunosuppressants1.

Active IBD can impair fertility

Women with inactive IBD have similar fertility rates as the general population, which varies from 1 in 10 couples to 1 in 6 couples. Active IBD is associated with decreased fertility so it is important that women who are trying to become pregnant speak to their physician to ensure their IBD is controlled and inactive.

Active IBD pre-pregnancy increases the risk of active IBD during pregnancy

IBD is associated with a slight increased risk of preterm delivery, small for gestational age infants, and miscarriages or spontaneous abortions compared to the general population2,3. These risks are increased even more in women who have active IBD.  Women who had active IBD within 3 months of conception are at risk of having active disease during pregnancy4. On the other hand, women who were in remission at time of conception will be more likely to stay in remission during pregnancy. Therefore, it is advised for women with IBD to aim to be in remission before attempting to become pregnant. 

REFERENCES

  1. Zelinkova Z et al. Reproductive wish represents an important factor influencing therapeutic strategy in inflammatory bowel diseases. Scand J Gastro. 2010; 45:46–50.
  2. Getahund D et al. Association between maternal inflammatory bowel disease and adverse perinatal outcomes. J Perinatol. 2014 June; 34(6):435-440. doi: 10.1038/jp.2014.41.
  3. Huang V W & Habal F M. From conception to delivery: Managing the pregnant inflammatory bowel disease patient. World J Gastroenterol. 2014;20(13).
  4. Oron G et al. Inflammatory bowel disease: risk factors for adverse pregnancy outcomes and the impact of maternal weight gain. J Matern Fetal Neonatal Med. 2012;25:2256-2260.