Global Consensus Statement on the Management of Pregnancy in Inflammatory Bowel Disease

Uma Mahadevan; Cynthia H Seow; Edward L Barnes; María Chaparro; Emma Flanagan; Sonia Friedman; Mette Julsgaard; Sunanda Kane; Siew Ng; Joana Torres; Gillian Watermeyer; Jesus Yamamoto-Furusho; Christopher Robinson; Susan Fisher; Phil Anderson; Richard Gearry; Dana Duricova; Marla Dubinsky; Millie Long; Global Consensus Group for Pregnancy and IBD

doi:10.1016/j.cgh.2025.04.005

Global Consensus Statement on the Management of Pregnancy in Inflammatory Bowel Disease

Clin Gastroenterol Hepatol. 2025 Oct;23(11S):S1-S60. doi: 10.1016/j.cgh.2025.04.005. Epub 2025 Aug 28.

Authors

Uma Mahadevan¹, Cynthia H Seow², Edward L Barnes³, María Chaparro⁴, Emma Flanagan⁵, Sonia Friedman⁶, Mette Julsgaard⁷, Sunanda Kane⁸, Siew Ng⁹, Joana Torres¹⁰, Gillian Watermeyer¹¹, Jesus Yamamoto-Furusho¹², Christopher Robinson¹³, Susan Fisher¹⁴, Phil Anderson¹⁵, Richard Gearry¹⁶, Dana Duricova¹⁷, Marla Dubinsky¹⁸, Millie Long³; Global Consensus Group for Pregnancy and IBD

Collaborators

Global Consensus Group for Pregnancy and IBD:
Maria Abreu¹⁹, Nahla Ali Azzam²⁰, Wafaa Badre²¹, Rupa Banerjee²², Sally Bell²³, Susan Connor²⁴, Iris Dotan²⁵, Marc Ferrante²⁶, Emily Finlayson²⁷, Ryota Hokari²⁸, Vivian Huang²⁹, Patricio Ibanez³⁰, Fabian Juliao³¹, Leolin Katsidzira³², Alicia Sambuelli³³, Christian Selinger³⁴, Shu-Chen Wei³⁵, Astrid Williams³⁶, Cyrla Zaltman³⁷, Jessica Lim³⁸, Nicole Arima³⁸, Wenli Chen³⁹, Natalie Hayden¹⁹, Heng Chun Lin¹⁹, Anne Brosbol Ravnborg¹⁹, Treza Njeri Mwaura-Ruhio¹⁹, Lindsay Rous¹⁹

Affiliations

¹ Division of Gastroenterology, Department of Medicine, University of California, San Francisco, California. Electronic address: uma.mahadevan@ucsf.edu.
² Inflammatory Bowel Disease Unit, Division of Gastroenterology and Hepatology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
³ Division of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
⁴ Gastroenterology Department, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Universidad Autónoma de Madrid (UAM), and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain.
⁵ Department of Gastroenterology, St Vincent's Hospital Melbourne, Australia, Department of Medicine, University of Melbourne, Melbourne, Australia.
⁶ Division of Gastroenterology and Hepatology, Tufts Medical Center, Boston, Massachusetts.
⁷ Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark, Institute of Clinical Medicine, Health, Aarhus University, Aarhus, Denmark.
⁸ Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota.
⁹ Microbiota I-Center (MagIC), Hong Kong SAR, China, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, SAR, China, Li Ka Shing Institute of Health Sciences, State Key Laboratory of Digestive Disease Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong SAR, China.
¹⁰ Division of Gastroenterology, Hospital da Luz Lisbon, Division of Gastroenterology, Hospital Beatriz Ângelo, Portugal Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.
¹¹ Department of Medicine University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa.
¹² Inflammatory Bowel Disease Clinic, Department of Gastroenterology, National Institute of Medical Sciences and Nutrition Salvador Zubiran, Mexico City, Mexico.
¹³ Charleston Maternal Fetal Medicine, East Cooper Medical Center, Mount Pleasant, South Carolina.
¹⁴ Department of Obstetrics and Gynecology, University of California, San Francisco, California.
¹⁵ Skaggs School of Pharmacy and Pharmaceutical Sciences, San Diego, California.
¹⁶ Department of Medicine, University of Otago, Christchurch, New Zealand.
¹⁷ Clinical and Research Center for IBD, ISCARE a.s., Prague, Czech Republic.
¹⁸ Division of Pediatric Gastroenterology, Susan and Leonard Feinstein IBD Clinical Center, Icahn School of Medicine, Mount Sinai, New York, New York.
¹⁹ Crohn's and Colitis Center, University of Miami Miller School of Medicine, Miami, Florida.
²⁰ Division of Gastroenterology, Department of Medicine, King Saud University, Riyadh, Saudi Arabia.
²¹ University Hospital Ibn Rochd, Casablanca, Morocco.
²² IBD Center, AIG Hospitals, Hyderabad, India.
²³ Department of Gastroenterology, Monash Health, Department of Medicine, Monash University, Melbourne, Australia.
²⁴ Liverpool Hospital, Sydney, Australia; University of New South Wales, Sydney, Australia; Ingham Institute of Applied Medical Research, Liverpool, Australia.
²⁵ Division of Gastroenterology at the Rabin Medical Center, Petah Tikva, Israel.
²⁶ Department of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium; Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium.
²⁷ Department of Surgery, Medicine, and Health Policy, University of California, San Francisco, San Francisco, California.
²⁸ Department of Internal medicine, National Defense Medical College, Saitama, Japan.
²⁹ Division of Gastroenterology and Hepatology, Department of Medicine, Sinai Health System, University of Toronto, Toronto, Ontario, Canada.
³⁰ Gastroenterology Unit, Internal Medicine Department, Clinica Alemana, Santiago, Chile.
³¹ Inflammatory Bowel Disease Clinic, Hospital Pablo Tobón Uribe, Medellín, Colombia.
³² Department of Internal Medicine, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe.
³³ Inflammatory Bowel Disease Section, Hospital Bonorino Udaondo, Buenos Aires, Argentina.
³⁴ Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom.
³⁵ Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
³⁶ Liverpool Hospital, Department of Gastroenterology and Hepatology, Liverpool, New South Wales, Australia.
³⁷ Department of Internal Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
³⁸ Division of Gastroenterology, Department of Medicine, University of California San Francisco, San Francisco, California.
³⁹ Center for Gastrointestinal Biology and Disease, University of North Carolina, Chapel Hill, North Carolina.

PMID: 40874901
DOI: 10.1016/j.cgh.2025.04.005

Abstract

Background & aims: Pregnancy can be a complex and risk-filled event for women with inflammatory bowel disease (IBD). High-quality studies in this population are lacking, with limited data on medications approved to treat IBD during pregnancy. For patients, limited knowledge surrounding pregnancy impacts pregnancy rates, medication adherence, and outcomes. Limited provider knowledge leads to highly varied practices in care affected by local dogma, available resources, individual interpretation of the literature, and fear of harming the fetus. The variations in guidelines by different societies and countries reflect this and lead to confusion for physicians and patients alike. The Global Consensus Consortium is a group of 39 IBD and content experts and 7 patient advocates from 6 continents who convened to review and assess current data and come to an agreement on best practices based on these data.

Methods: The GRADE (Grading of Recommendations Assessment, Development, and Evaluation) process was used when sufficient published data were available and the RAND (Research and Development) process in those instances where expert opinion was needed to guide consistent practice. Recommendations were informed by the guiding principle that maternal health best supports infant health.

Results: The topics were divided into ten categories with 34 GRADE recommendations and 35 consensus statements.

Conclusions: Overall, the goal of the group was to provide data-driven and practical guidance to improve the care of women with IBD around the globe based on the best available research.

Keywords: Biologics; Crohn’s Disease; Inflammatory Bowel Disease; JAK Inhibitors; Pregnancy; Ulcerative Colitis.

Publication types

Consensus Statement

MeSH terms

Disease Management*
Female
Humans
Inflammatory Bowel Diseases* / complications
Inflammatory Bowel Diseases* / drug therapy
Inflammatory Bowel Diseases* / therapy
Pregnancy
Pregnancy Complications* / drug therapy
Pregnancy Complications* / therapy