IBD and Pregnancy: Important Facts You Should Know
Every case of inflammatory bowel disease (IBD) is unique to each person. So how IBD affects pregnancy will differ for every expectant mother. Someone with IBD who is expecting is considered a high-risk pregnancy for a variety of reasons. Dr. Constance A. Pietrzak, a gastroenterologist for a Chicago private practice, discusses the risks and essential information IBD patients should know before starting a family.
Many IBD patients suffer from nutrient deficiency and weight loss due to malabsorption. “This can affect the growth and maturation of the fetus,” explains Pietrzak. She recommends vitamin screenings. Consult a nutritionist for a nutrient-dense diet. Pietrzak says it’s crucial for your GI and obstetrician (OB) to work closely together throughout your pregnancy for optimal health and safety.
Pietrzak says most IBD medications are safe to take while pregnant or trying to conceive. Only a few IBD medications are known to negatively impact pregnancy and conception: methotrexate, sulfasalazine, ciprofloxacin, and metronidazole. Talk to your doctor about these medications and any other medications you may be taking if you’re pregnant or wish to become pregnant.
While flares are treated the same whether you’re pregnant or not, it’s important to get a flare under control as quickly as possible. Flares can lead to dehydration and poor health, negatively impacting the fetus. Do not try to conceive while you’re experiencing a flare. Pietrzak estimates that one-third of IBD patients will have a flare during pregnancy.
“Pregnant patients may be at increased risk for premature delivery, low birth weights, and antepartum hemorrhage (bleeding prior to child delivery),” says Pietrzak. “IBD patients, especially those in the third trimester or with active disease, should follow with a high-risk OB.”
Depending on where IBD affects the digestive tract, some patients may need a C-section. For example, Pietrzak says patients with Crohn’s disease affecting the perineum and rectum should do a C-section to avoid damaging the area. C-sections are also recommended for people with J-pouches, but people with a colostomy or ileostomy can safely undergo vaginal delivery. Follow the advice of your obstetrician.
Breastfeeding will not worsen IBD and is safe for most patients. However, certain medications should be avoided while breastfeeding, such as metronidazole. Talk with your doctor if you’re interested in breastfeeding.
“IBD is linked to genetic factors and, therefore, children of parents with IBD are about three to 20 times more likely to develop IBD compared to the general population,” explains Pietrzak. While your child isn’t guaranteed to develop IBD, it’s important to recognize the probabilities.