Pregnancy is an exciting journey, and for individuals with Inflammatory Bowel Disease (IBD), being in remission before conception is crucial. In this article, we aim to provide some guidance for those with IBD who are planning to start a family or are already expecting.

Q: Why is being in remission before considering a pregnancy so important for individuals with IBD?

A: Being in remission before pregnancy is vital because the disease's activity at the time of conception is closely linked to pregnancy complications such as premature birth, low birth weight, and other adverse outcomes. Recent research suggests that only patients who experienced active disease or flare-ups during pregnancy show higher complication rates.

Q: How does the degree of disease activity affect pregnancy outcomes for those with IBD?

A: The degree of disease activity is a significant factor. Active IBD directly impacts patients' nutritional status and increases the risk of complications during pregnancy for both the mother and the newborn. Inadequate weight gain during pregnancy is associated with active disease, leading to a higher rate of complications.

Q: What can the IBD healthcare team do to support those planning for pregnancy?

A: The IBD healthcare team plays a crucial role in preconception counselling. They help individuals establish remission by optimizing their treatment plans. This process involves reviewing medication, assessing nutrition, and ensuring that the patient's overall health is in the best possible condition before conception. They provide support and guidance to promote healthier behaviours and reduce the risk of complications during pregnancy.

Q: How does pregnancy generally affect the course of IBD when in remission?

A: For individuals in remission before conception, pregnancy is generally a safe and positive experience. The risk of disease reactivation during pregnancy is lower, and most pregnancies proceed smoothly without major complications. Maintaining remission for more than 6 months before trying to conceive, as advised by organizations like the European Crohn's and Colitis Organization (ECCO), significantly contributes to the safety and success of pregnancies.

Q: What should a patient do if they are considering getting pregnant?

A: If you're considering getting pregnant, it's essential to inform your IBD healthcare team and your general practitioner (GP). They will play a vital role in helping you plan a safe and successful pregnancy by ensuring your IBD is well-managed, reviewing your medication, and providing guidance on optimizing your health before conception.

Q: What if I become pregnant unexpectedly?

A: If you become pregnant unexpectedly, it's important to remember that, for most individuals with IBD, pregnancy is probably fine. However, you should immediately inform your IBD healthcare team. In the case of unexpected pregnancy, it's crucial to continue taking your normal medications, except for methotrexate, which you should stop immediately and inform your healthcare team. They will guide you through the necessary adjustments to ensure a healthy and successful pregnancy.

Conclusion

The importance of being in remission before considering a pregnancy cannot be overstated for individuals with Inflammatory Bowel Disease. For those in remission, the outlook for pregnancy is reassuring, with most pregnancies being safe and successful.

Preconception counselling and education, with the support of your IBD healthcare team, are key to ensuring your IBD is well-managed before you conceive, ultimately leading to better pregnancy outcomes.

You are not alone in this journey. Seek guidance from your IBD team, join support groups, and stay informed. With the right approach and proper care, you can embrace the joys of parenthood while living with IBD.