Curbside Consultation in IBD: 49 Clinical Questions, Second Edition

David T Rubin, MD; Sonia Friedman, MD; Francis A Farraye, MD MSc

Question 45: What Is The Updated Approach To Antimetabolites And Biologic Therapy In Inflammatory Bowel Disease And Pregnancy? (continued)

Uma Mahadevan, MD

Management of inflammatory bowel disease (IBD) in pregnancy is a delicate balancing act among the safety of the mother, the safety of the infant, and the rational and irrational concerns of all involved. Based on the literature to date, IBD is associated with an increased risk of adverse pregnancy outcomes, particularly in patients with active disease.1,2 Thus, the health needs of mother and infant overlap because inducing and maintaining remission in the mother is the key to a successful pregnancy. This may require the use of antimetabolites and biologic therapy during pregnancy and…