Summary of New Global Guidelines for IBD and Pregnancy (August 28, 2025)
This article details new global guidelines developed by the Helmsley PIANO Expert Global Consensus to improve care for pregnant individuals with Inflammatory Bowel Disease (IBD). Historically, a lack of data on medication safety during pregnancy led to uncertainty and potential risks for both mother and child. The PIANO study addressed this gap by examining the safety of IBD medications and assessing outcomes for exposed children.
Key Recommendations:
Continue Biologics: All biologic medications should be continued throughout pregnancy and lactation.
Preconception Counseling: Universal preconception counseling is crucial for women with IBD, ideally aiming for remission for 3-6 months before conception. High-Risk Pregnancy: Women with IBD should be managed as high-risk pregnancies.
Aspirin for Preeclampsia: Low-dose aspirin starting at 12-16 weeks can help prevent preterm preeclampsia.
Routine Vaccinations: Infants of mothers with IBD should receive routine vaccinations, including rotavirus.
Medication Guidance:
Continue: 5-ASAs, sulfasalazine, thiopurines, and all monoclonal antibodies during preconception, pregnancy, and lactation.
Avoid: Small molecule drugs should be avoided for 1-3 months prior to conception and during lactation, unless no choice exists.
Meaning:
These guidelines represent the first truly global effort to standardize and improve care for women with IBD during pregnancy,offering hope and comfort by providing evidence-based recommendations and reducing uncertainty surrounding medication safety. The study was published in six leading international journals,solidifying its impact on the field.
