Multidisciplinary Perinatal Care in IBD.

Lihi Godny, Vaios Svolos, Astrid-Jane Williams, Wladyslawa Czuber-Dochan, Marina Aloi, Ana Ibarra, Dearbhaile V O'Hanlon, Gabriele Dragoni, Irit Avni Biron, Marjo Campmans-Kuijpers, Paul Collins, Piotr Eder, Tamar Pfeffer-Gik, Susanna Jäghult, Catherine L Wall

Journal: Journal of Crohn's & colitis 2023;17(5):663-680

PMID: 36541887

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Abstract

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.

Address: Division of Gastroenterology, Rabin Medical Center, Petah-Tikva, Israel.; Nutrition Unit, Rabin Medical Center, Petah-Tikva, Israel.; Faculty of Health Sciences, Metropolitan College, Larisa, Greece.; Human Nutrition, School of Medicine, Dentistry & Nursing, College of Medical, Veterinary, and Life Sciences, University of Glasgow, Glasgow, UK.; Department of Gastroenterology, Liverpool Hospital, Sydney, Australia.; South Western Sydney Local Health District Clinical School, University of New South Wales, Sydney, Australia.; Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK.; Pediatric Gastroenterology Unit, Department of Maternal and Child Health, Sapienza University, Umberto I Hospital, Rome, Italy.; Inflammatory Bowel Disease, Barts Health NHS Trust, London, UK.; Nutrition & Dietetics, Guy's & St. Thomas's NHS Foundation Trust, London, UK.; IBD Referral Center, Department of Gastroenterology, Careggi University Hospital, Florence, Italy.; Gastroenterology Research Unit, Department of Experimental and Clinical Biochemical Sciences 'Mario Serio', University of Florence, Florence, Italy.; Division of Gastroenterology, Rabin Medical Center, Petah-Tikva, Israel.; Department of Gastroenterology and Hepatology, University Medical Center Groningen, Groningen, the Netherlands.; Department of Gastroenterology and Hepatology, Royal Liverpool University Hospital, Liverpool, UK.; Department of Gastroenterology, Dietetics and Internal Medicine, Poznań University of Medical Sciences, Poznań, Poland.; Division of Gastroenterology, Rabin Medical Center, Petah-Tikva, Israel.; Nutrition Unit, Rabin Medical Center, Petah-Tikva, Israel.; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.; Karolinska Institute Danderyd Hospital, Stockholm, Sweden.; Nutrition & Dietetics, Te Whatu Ora Waitaha Canterbury, Christchurch, New Zealand.; Department of Medicine, University of Otago, Christchurch, New Zealand.

DOI: 10.1093/ecco-jcc/jjac189

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MeSH Terms: Female, Humans, Pregnancy, Infant, Newborn, Child, Perinatal Care, Inflammatory Bowel Diseases, Crohn Disease, Pregnancy Outcome, Gastroenterologists