Inflammatory bowel disease in pregnancy: Developing a multidisciplinary care pathway in East London

Objectives: Evaluate the management of pregnant women with inflammatory bowel disease. Method: We collected data from maternity records for women with IBD who gave birth at The Royal London Hospital between January 2018 and February 2019. Results: Twenty-three pregnancies were identified where 8/23 (35%) women had a peri-conception flare and 7/23 (30%) had a flare during pregnancy. Two women received pre-conception counselling. The obstetric medicine team reviewed a patient on average three times and the gastroenterologists twice, during pregnancy. Nine women (39%) gave birth pre-term. Mean birthweight was lower in the group with active disease at conception compared with those in remission (2173 g vs. 2807 g, p = 0.03). Conclusions: Women with IBD should all receive pre-conception counselling to reduce the risk of pregnancy complications. By developing a multidisciplinary care pathway for pregnant women with IBD (which includes a joint obstetric/gastroenterology clinic), this will ensure care is standardised throughout the pregnancy and puerperium.