The latest guidelines for managing inflammatory bowel disease from conception to pregnancy and breastfeeding.
Inflammatory bowel disease (IBD) poses challenges for individuals planning a family due to its impact on fertility, pregnancy, and lactation. The risk of IBD in offspring increases if one or both parents have the condition, emphasizing genetic predisposition. Fertility in individuals with IBD is typically similar to the general population, but active disease, certain surgeries, and complications like perianal Crohn's disease can affect fertility. Maintaining disease remission before pregnancy is crucial to reduce pregnancy complications. Flaring IBD during pregnancy can lead to adverse outcomes such as preterm birth, highlighting the importance of managing the disease with appropriate medications. The safety of medications during pregnancy is vital, as most have minimal fetal risks, and stopping medication can pose risks to both the parent and fetus.
Preconception counseling is essential to discuss fertility, medication management, and IBD heritability. Improved access to digital tools can aid in providing tailored education and support for individuals with IBD. Studies show that a significant number of individuals with IBD lack adequate knowledge about reproductive health and might make decisions without consulting healthcare providers, indicating the need for better education and support systems.
During pregnancy, regular prenatal care is crucial, including monitoring iron, vitamin B12, and folic acid levels. Managing disease activity through medication and monitoring is key to ensuring healthy outcomes for both the parent and the baby. Medication adherence is essential, as discontinuing medications can lead to disease flares and adverse pregnancy outcomes. Various medications used for IBD have different safety profiles during pregnancy and lactation, emphasizing the importance of informed decision-making and close monitoring.
Choosing the appropriate delivery mode is a shared decision between the individual, obstetrician, and healthcare team. Vaginal delivery is generally suitable for most individuals with IBD, while caesarean delivery might be recommended for specific cases, such as those with active perianal disease or IPAA. Postpartum wound healing and resuming biologic therapy after delivery should also be carefully managed to prevent complications.
Lactation offers benefits for both the parent and the infant, and most IBD medications are considered safe during breastfeeding. Vaccinations for infants exposed to medications during pregnancy should be carefully considered to ensure their safety. Data on paternal medication exposure and its impact on offspring outcomes are reassuring, highlighting the importance of comprehensive care and support for individuals with IBD planning for parenthood.
In conclusion, optimizing IBD management from preconception to pregnancy and lactation is crucial for ensuring successful outcomes for individuals with the condition. Multidisciplinary support, education, and close monitoring play a vital role in guiding decision-making and promoting the well-being of both the parent and the baby throughout the reproductive journey.
Source: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)00052-7/fulltext
Preconception counseling is essential to discuss fertility, medication management, and IBD heritability. Improved access to digital tools can aid in providing tailored education and support for individuals with IBD. Studies show that a significant number of individuals with IBD lack adequate knowledge about reproductive health and might make decisions without consulting healthcare providers, indicating the need for better education and support systems.
During pregnancy, regular prenatal care is crucial, including monitoring iron, vitamin B12, and folic acid levels. Managing disease activity through medication and monitoring is key to ensuring healthy outcomes for both the parent and the baby. Medication adherence is essential, as discontinuing medications can lead to disease flares and adverse pregnancy outcomes. Various medications used for IBD have different safety profiles during pregnancy and lactation, emphasizing the importance of informed decision-making and close monitoring.
Choosing the appropriate delivery mode is a shared decision between the individual, obstetrician, and healthcare team. Vaginal delivery is generally suitable for most individuals with IBD, while caesarean delivery might be recommended for specific cases, such as those with active perianal disease or IPAA. Postpartum wound healing and resuming biologic therapy after delivery should also be carefully managed to prevent complications.
Lactation offers benefits for both the parent and the infant, and most IBD medications are considered safe during breastfeeding. Vaccinations for infants exposed to medications during pregnancy should be carefully considered to ensure their safety. Data on paternal medication exposure and its impact on offspring outcomes are reassuring, highlighting the importance of comprehensive care and support for individuals with IBD planning for parenthood.
In conclusion, optimizing IBD management from preconception to pregnancy and lactation is crucial for ensuring successful outcomes for individuals with the condition. Multidisciplinary support, education, and close monitoring play a vital role in guiding decision-making and promoting the well-being of both the parent and the baby throughout the reproductive journey.
Source: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)00052-7/fulltext
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