Nearly 1 in 100 Canadians has inflammatory bowel disease. Too many believe it rules out having children

A study conducted in 2025 reveals that nearly 1% of Canadians are affected by inflammatory bowel disease (IBD), a chronic condition that primarily affects young people. Historically, women with IBD were advised to avoid pregnancy due to concerns about disease activity and complications. However, modern treatments have transformed the landscape, with biologics enabling lasting remission and improved quality of life.

These medications raise questions about potential risks to unborn children, but modern evidence shows that most IBD drugs do not increase the risk of birth defects, miscarriage, preterm birth, or infection in babies. The key lies in monitoring disease activity; active inflammation detected via imaging, endoscopy, stool, or blood tests can pose risks, particularly if untreated.

Modern medications like biologics, azathioprine, and 5-aminosalicylic acid are generally safe to continue throughout pregnancy and breastfeeding. However, corticosteroids should be limited to treating active disease due to their link with premature and low-birth-weight babies. Certain drugs, like methotrexate, should be avoided due to serious birth defects.

The consensus statement emphasizes that with good preconception control, the likelihood of active disease during pregnancy significantly decreases. Regular monitoring through blood work, stool tests, and possibly intestinal ultrasound can help detect any changes in disease activity. While pregnancy can bring gastrointestinal symptoms, these are often benign.

Close and regular monitoring is essential, making ultrasound a valuable tool, especially when symptoms are absent but inflammation may still be present.