Crohn's Disease and Ulcerative Colitis: Preconception to Pregnancy

This clinical overview examines the complex relationship between inflammatory bowel disease (IBD) and pregnancy, emphasizing that maintaining disease remission is the most critical factor for healthy outcomes. The authors highlight that while active inflammation increases the risk of complications like preterm birth and low birth weight, most maintenance medications, including biologics, are safe and should be continued. Preconception counseling is recommended to address patient concerns regarding fertility and the safety of nursing while on treatment. The text also provides specific guidance on diagnostic imaging, the safety of various drug classes, and delivery methods, noting that vaginal birth is generally appropriate unless active perianal disease is present. Ultimately, a multidisciplinary approach involving gastroenterologists and obstetricians is presented as the gold standard for managing IBD during the reproductive years.