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Multidisciplinary Perinatal Care in IBD
Lihi Godny1,2, Vaios Svolos3,4, Astrid-Jane Williams5,6
1Division of Gastroenterology, Rabin Medical Center, Petah-Tikva, Israel.
Insights
Women with inflammatory bowel disease [IBD] need specialized perinatal care. A multidisciplinary team [MDT] approach optimizes nutritional, psychological, and supportive care for mothers and infants, addressing IBD risks.
Area of Science:
- Gastroenterology
- Perinatal Medicine
- Pediatrics
Background:
- Inflammatory bowel disease [IBD] significantly impacts women during reproductive years.
- Perinatal care for IBD patients requires a multidisciplinary team [MDT] approach.
- Unique nutritional and psychosocial needs affect fertility and pregnancy outcomes in IBD patients.
Purpose of the Study:
- To review scientific evidence on nutritional, psychological, and supportive care for IBD patients and their infants.
- To provide expert opinion on optimal care throughout preconception, pregnancy, and infancy.
- To assess the impact of early-life exposures on IBD development in offspring.
Main Methods:
- A consensus expert panel convened by the European Crohn's and Colitis Organisation.
- Literature review on non-medical management of IBD during preconception, pregnancy, and early childhood.
- e-Delphi process with ≥80% expert agreement to develop practice positions.
Main Results:
- 19 current practice positions developed covering preconception, pregnancy, lactation, and early-life exposures.
- Reviewed infant microbiome development, immune system roles, nutritional optimization, and psychological support.
- Identified associations between early-life environment and subsequent IBD development.
Conclusions:
- IBD patients have distinct nutritional and psychosocial needs impacting fertility and pregnancy.
- Early-life factors in infants of IBD parents may influence offspring IBD risk.
- A multidisciplinary team [MDT] provides optimal support and counseling during the perinatal period.
Background And Aims:
Patients with inflammatory bowel disease [IBD] are often affected during their reproductive years and may have many perinatal queries that require the comprehensive perspectives of a multidisciplinary team [MDT]. The purpose of this topical review is to assess the scientific evidence and provide expert opinion related to nutritional, psychological and supportive care of women and their infants throughout the prenatal, antenatal and infant periods.
Methods:
A consensus expert panel of a paediatrician, gastroenterologists, nurses and dietitians was convened by the European Crohn's and Colitis Organisation. This panel critically reviewed literature related to the non-medical management of patients with IBD during preconception, pregnancy, the postnatal period and the first years of the infant's life. Statements were developed using an e-Delphi process over two rounds and were confirmed when ≥80% of experts agreed with the statements.
Results:
A total of 19 current practice positions were developed that cover the preconception period, pregnancy and lactation, and early-life exposures associated with risk of IBD. Development of the infant microbiome and its role in the immune system and topics including nutritional optimization, psychological support and education relating to early life were reviewed.
Conclusions:
Patients with IBD have unique nutritional and psychosocial needs that may affect fertility and pregnancy outcomes. The early-life environment of infants born to parents with IBD may be associated with subsequent development of IBD in offspring. An MDT is the optimal setting to support and counsel patients throughout the perinatal period.
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