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A Guide to Ulcerative Colitis and Pregnancy

Overview

Women with inflammatory bowel diseases like ulcerative colitis (UC) can have healthy pregnancies. However, you’ll need to keep a few important things in mind so that you and your baby are well-nourished during your pregnancy. It’s important to work with your doctor and a dietician throughout your pregnancy. They’ll be able to help you find the best and safest way to manage your symptoms and flare-ups. Here’s more information about UC and pregnancy.

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Pregnancy and UC

How will pregnancy affect ulcerative colitis?

In an ideal world, you would become pregnant during a period of disease inactivity or remission. Your body would also remain flare-free for the nine months that you’re pregnant. Unfortunately, that’s not always how it works.

Most women with UC carry their babies to term without complication. However, women with the disease are more likely than women of the same age without the disease to experience a miscarriage, premature delivery, and labor and delivery complications.

UC flare-ups are most likely to occur during the first trimester or immediately following delivery. For that reason, your obstetrician may classify yours as a high-risk pregnancy.

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Diet

Diet during pregnancy with UC

The large intestine of a person with UC may not be able to absorb nutrients, vitamins, and minerals as easily as it would if UC wasn’t present. That’s why proper nutrition is extremely important if you are pregnant and have UC.

You will receive prenatal vitamins which include nutrients like folic acid. This is especially important for women with UC, because some UC treatments lower your folic acid levels.

Ask your gastroenterologist or obstetrician about making an appointment with a dietitian. During this important time in your life, you may want expert help with creating a diet that works for your condition. Your doctor can help ensure that you’ll have a proper, balanced meal plan, and you can rest easy knowing that you’re giving your body — and your baby-to-be’s — all the needed nutrition.

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Treatment options

Safe treatments for UC during pregnancy

It’s not necessary to stop all your treatments if you find out you’re pregnant. In many cases, the medicines are perfectly safe for both you and your baby. Stopping treatment may in fact make your condition worse.

According to the Crohn’s and Colitis Foundation of America, if a woman stops her treatment regimen and then her UC flares, she may not be able to easily control her condition again. This may lead to additional health problems, including some that can harm the baby.

If you experience a flare while you are pregnant, or are experiencing a flare when you find out that you’re pregnant, your doctor may need to re-evaluate your treatment plan. Many medications used for treating the signs and symptoms of UC are safe for pregnant women. These include the following.

Aminosalicylates and 5-ASA compounds: Both appear to be safe for developing babies, and women taking a 5-ASA compound are able to breast-feed.

Corticosteroids: These hormone injections, such as prednisone, are considered low-risk treatments for most pregnant and nursing women.

Immunomodulators and immunosuppressants: Most medicines in both classes are considered low-risk during pregnancy. If you’re taking methotrexate to treat your bowel symptoms, it’s important that you explain to your doctor your plans to become pregnant. Methotrexate is potentially toxic to developing babies and to newborns who are breast-fed.

Biologics: Biologic compounds are considered low-risk for early trimester pregnancy. They can also be prescribed to women who are nursing.

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Dangers for baby

Is ulcerative colitis dangerous for your baby-to-be?

UC is genetic, and there’s a slight chance you will pass it to your child. If you have UC but your partner does not, the risk that your child will have the disease is less than 10 percent.

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Bottom line

Bottom line

No two people experience UC in the same way. Some women with it have normal, healthy pregnancies. Others have a more difficult time. If you’re pregnant or thinking about becoming pregnant, it’s important to work with your gastroenterologist and obstetrician. They can make sure you have the best chances of conceiving and carrying to term without complications or setbacks.

  • What are some tips for keeping UC symptoms and flare-ups under control during pregnancy?
  • Like many chronic illnesses, it is important to try and begin the pregnancy with the problem under the best control possible. You may want to consult with your healthcare provider before you conceive to see if they believe it would be safe to be pregnant. After conception, never change your treatment plan without first consulting your physicians. As a general rule for pregnancy, a healthy diet, exercise, and proper rest are always beneficial. If you feel that you are having a flare-up, do not hesitate to consult your physician to see what the next steps in your therapy should be.

    - Michael Weber, MD
  • Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
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