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Pregnant Women with Inflammatory Bowel Disease Has an Increased Risk of Complications


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Inflammatory bowel disease (IBD) is a chronic disease of the digestive tract that is also associated with an increased risk of complications during pregnancy. 

Therefore, it is best to schedule your pregnancy when you are in remission from your IBD and avoid pregnancy if you’re experiencing symptoms. 

If you suspect that you might have this condition, talk to your doctor and seek a referral to a maternal-fetal medicine specialist. Treatment for inflammatory bowel disease has evolved over the past two decades. 

Today, biologics help people with IBD keep flare-ups at bay. However, the risk of complications remains high among pregnant women with IBD.

In this article, we are going to discuss why pregnant women with inflammatory bowel disease are at an increased risk of developing complications.

About Inflammatory Bowel Disease

This chronic inflammatory disorder affects the lining of the colon. It is caused by an inappropriate response of the immune system to environmental triggers, such as bacterial invasion. This condition also has a genetic component, as people with a family history of the disease are more likely to develop the disease.

The term IBD is often used to describe two conditions, i.e. ulcerative colitis and Crohn’s disease. These are long-term conditions that cause inflammation of the gut. While ulcerative colitis only affects the large intestine, Crohn’s disease can affect various parts of the digestive system, i.e. from mouth to anus. 

IDB is mostly diagnosed in people between the ages of 15 to 40 years. Treatments include surgery to remove damaged portions of the gastrointestinal tract. The symptoms of IBD can mimic a number of other diseases, but it is distinct from them.

Treatments for IBD can range from medications to surgery. Medication can treat mild inflammation of the colon and intestine. Medications include 5-ASA, immunomodulators, biologics, and corticosteroid therapies. 

Surgery can sometimes restore quality of life. But while medications can help a person manage the symptoms of this disease, the treatment options are limited and often require a biopsy. Therefore, it is important to determine the cause of inflammation and treatment options.

Anti-inflammatory drugs are the first line of treatment for IBD. If you’re experiencing mild symptoms, your doctor may prescribe fast-acting anti-inflammatory drugs to treat your flare. However, these drugs should only be used for short periods of time – longer use can worsen the condition. 

Pregnant Women with IBD Has an Increased Risk of Complications

If you have IBD and are planning for a pregnancy, you may be wondering why this disease increases the chances of complications. Although biologics have changed the treatment of IBD, the risks of pregnancy complications in women with Crohn’s disease and ulcerative colitis remain high. 

Although research on this topic has been minimal and clinical trials are considered risky, there is a link between pregnancy complications and IBD disease. Pregnant women with IBD are at increased risk for preeclampsia, preterm birth, fetal growth restriction, and the potential for Cesarean delivery.

During the study, Kaiser Permanente Southern California facilities treated 395,781 singleton pregnancies. Of these, 130 women had IBD. The women with IBD were more likely to have a preterm delivery, spontaneous preterm birth, and small for gestational age. Their children were almost twice likely to develop preterm as their peers. 

The disease can interfere with fertility and reduce a woman’s chances of becoming pregnant. Fortunately, the majority of women with Crohn’s disease deliver healthy babies. Still, it is important for women with Crohn’s disease to follow their treatment guidelines to minimize the risks of complications. The most important aspect of treatment in the perinatal period is keeping the disease in remission.

If the mother has a history of IBD, the care for her pregnancy may be shared between the gastroenterologist and obstetrician. The obstetrician may schedule visits based on the severity of her disease. The gastroenterologist will see the woman every two weeks from the time she reaches 28 weeks. The obstetrician will see her once a week until the baby is delivered. The visits will include urine and blood tests.

Because people with IBD need medication to control their disease, they need to consider the safety of medications during pregnancy. While most medications have minimal risk during pregnancy, there is no definitive information about the safety of some drugs. 

Therefore, women with IBD should talk with their healthcare provider before discontinuing these medications. If they choose to discontinue the medications, it is important to understand the risks associated with a flare. A flare is a more serious risk to a woman’s pregnancy than the medications that are often prescribed.

For women with IBD, it is essential to take medication before conception. Inflammatory bowel disease can cause pregnancy complications in women, especially those who are breastfeeding. Inflammatory bowel disease has a significant impact on fertility, pregnancy, and lactation, so it is important to consider the needs of the mother and fetus before making the decision to have a child. 

If you or your partner suffers from IBD, discuss your delivery options with your healthcare provider. The severity of your IBD will determine the type of delivery your doctor will recommend. Your choice may depend on the type of Crohn’s disease impacted and the type of delivery you choose. In some cases, women with IBD with a high risk of fistulas may be better off having a cesarean delivery, although this isn’t required.

Symptoms of Inflammatory Bowel Disease

Inflammatory bowel disease can affect any part of the digestive tract, though it typically affects the colon and the small intestine. You may experience abdominal pain and frequent diarrhoea containing blood or pus. 

You may also develop fever, chills, and weight loss. In some cases, this disease can also affect the eyes, lungs, and joints. There is no known cure for IBD, but you can try various medications to manage your symptoms. Here are some common symptoms of this disease.

  • Diarrhoea
  • Abdominal pain and cramping
  • Extreme tiredness
  • Cramps or swelling in the tummy
  • Blood in your stool
  • Reduced appetite
  • Unintended weight loss

Causes of Inflammatory Bowel Disease

While there isn’t a definitive cause for inflammatory bowel disease, there are some known triggers. Infections from bacteria or viruses, certain foods, smoking, stress and genetics all appear to be risk factors. 

An inflammatory bowel disease is a group of autoimmune diseases characterized by chronic inflammation and bowel obstruction. Two of the most common forms of this disease are ulcerative colitis and Crohn’s disease. Studies have linked IBD to diet, sleep and immune system malfunction. Here are some causes of IBD.

  • Genetics
  • Diet and stress
  • Immune system malfunction

People with IBD can experience flare-ups anywhere in the gastrointestinal tract. As the inflammation progresses, the intestine wall becomes thick and scarred, narrowing the passageway and limiting the ability to live a normal life. A diagnosis of IBD is crucial in helping people prevent its complications. Here are the risk factors for IBD.

  • Age
  • Family history
  • Cigarette smoking
  • Race or ethnicity
  • Nonsteroidal anti-inflammatory medications

Treatment Options for Inflammatory Bowel Disease

There are many treatment options for Inflammatory Bowel Disease. While there are no definite cures for this condition, many medications and surgical procedures can relieve symptoms and improve overall health. Many of the available medications and therapies target the immune system and can dampen an overactive response. 

There are several types of  Inflammatory Bowel Disease (IBD) medications, and finding the right one for you will help you get the results you’re looking for. Here are some common treatment options for people suffering from IBD.

  • Immunosuppressants
  • Aminosalicylates or mesalazine
  • Antibiotics
  • Anti-inflammatory drugs
  • Biological and Biosimilar medicines
  • Surgery for ulcerative colitis
  • Surgery for Crohn’s disease
  • Pain relievers
  • Anti-diarrheal medications
  • Vitamins and supplements


Inflammatory bowel disease is a chronic condition that affects the digestive system and leads to various other problems. Research states that women suffering from IBD have an increased risk of complications. While there is no concrete evidence, it is still a major concern for pregnant women. It can lead to preterm delivery as well as fetal growth restriction. However, there are various medicines and treatment options to control the symptoms of IBD. So, if you have IBD, make sure you consult your doctor before you plan your pregnancy. 


What Causes Inflammatory Bowel Disease?

It’s not completely clear what causes Inflammatory Bowel Disease, but it has many common characteristics. The disease may run in families, and doctors aren’t sure exactly how it happens. Several different genes are known to increase the risk of developing the disorder. It’s thought that IBD is an autoimmune condition that causes the body’s immune system to attack healthy cells

What Are the Complications of Inflammatory Bowel Disease?

Inflammatory bowel disease is a reoccurring problem of the colon that damages the walls. Inflammation can affect any part of the GI tract but most commonly occurs in the small intestine before reaching the large intestine and colon. Damaged areas will appear next to healthy tissue. Continuous areas begin at the rectum and progress into the colon. Because the GI tract has multiple layers, inflammation can affect the entire tract.

Does Inflammatory Bowel Disease Affect Fertility?

Although the majority of women with IBD do not experience decreased fertility, there is still a possibility that it could reduce a woman’s ability to become pregnant. In some cases, women with IBD can experience reduced fertility if the disease is inactive. However, if severe inflammation occurs in the small intestine, it can affect fertility. 

Somapika Dutta (B.Sc Physiology, Honours)
Somapikar holds Bachelors Degree in Physiology from University of Culcutta. She has 6+ years of experience writing in different niches, including health, tech and lifestyle. An animal enthusiast and a raging foodie, experiencing life - one day at a time.


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