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 C. Ng, Joana Torres, Gillian Watermeyer, Jesús K. Yamamoto‐Furusho, Christopher Robinson, Susan Fisher, Phil Anderson, Richard B. Gearry, Dana Ďuricová, Marla Dubinsky, Millie D. Long, Global Consensus Group for Pregnancy and IBD, Abreu Maria, Azzam Nahla Ali, Badre Wafaa, Banerjee Rupa, Bell Sally, Connor Susan, D Iris, Ferrante Marc, Feneberg Emily, Hokari Ryota, Huang Vivian, Ibanez Patricio, Fabián Juliao, Katsidzira Leolin, Sambuelli Alicia, Selinger Christian, Shu‐Chen Wei, Williams Astrid, Cyrla Zaltman, L Thomson Jessica, A. Capela Nicole, Chen Wenli, Hayden Natalie, Lin Chun, Ravnborg Anne Brosbol, Mwaura-Ruhio Treza Njeri, Rous Lindsay
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.