Some people with IBD may remain childless because of a concern that children could inherit their disease. In recent years, there has been a focus on the idea that IBD runs in families and may even be linked to particular genes. Researchers have no clear answers about how IBD is passed between generations, but there is some research on the probability of children inheriting their parent's disease.
There seems to be a stronger risk of inheriting Crohn's disease than ulcerative colitis, especially in Jewish families. However, children who have one parent with Crohn's disease have only a 7 to 9% lifetime risk of developing the condition, and just a 10% risk of developing some form of IBD. If both parents have IBD, this risk is increased to about 35%.
Is there anything that will help before conception or during pregnancy?Women are now encouraged to get their bodies prepared for a pregnancy by increasing intake of folic acid, quitting smoking, getting more exercise, and eating healthier. For women with IBD, the greatest factor influencing the course of the pregnancy and the health of the baby is the state of disease activity. Discontinuing any medications that may be harmful to the developing fetus is also important. A pregnancy planned when the IBD is in remission has the greatest chance for a favorable outcome.
Sources:
Eisenberg S, Friedman LS. "Inflammatory bowel disease in pregnancy." Practical Gastroenterol 1990.
E M Alstead. "Inflammatory bowel disease in pregnancy." Postgraduate Medical Journal 2002. Jul 27 2007.
Akbar Waljee, Jennifer Waljee, Arden Morris, Peter D.R. Higgins. "Three-fold increased risk of infertility: a meta-analysis of infertility after pouch surgery in ulcerative colitis." Gut 13 June 2006. Jul 27 2007.
Norgard B, Czeizel AE, Rockenbauer M, et al. "Population-based case control study of the safety of sulfasalazine use during pregnancy." Aliment Pharmacol Ther 2001. Jul 27 2007.
Habal FM, Hui G, Greenberg GR. "Oral 5-aminosalicylic acid for inflammatory bowel disease in pregnancy: safety and clinical course." Gastroenterology 1993. Jul 27 2007.
Janssen NM, Genta MS. "The effects of immunosuppressive and anti-inflammatory medications on fertility, pregnancy, and lactation." Arch Intern Med 2000. Jul 27 2007.
Burtin P, Taddio A, Ariburnu O, et al. "Safety of metronidazole in pregnancy: a meta-analysis." Am J Obstet Gynecol 1995. Jul 27 2007.
Dayan A, Rubin P, Chapman M, Present D. "6-Mercaptopurine (6MP) use in inflammatory bowel disease (IBD) in patients of childbearing age: an increase in congenital anomalies--a case-controlled study." Gastroenterology 1991.
Alstead EM, Ritchie JK, Lennard-Jones JE, et al. "Safety of azathioprine in pregnancy in inflammatory bowel disease." Gastroenterology 1990. Jul 27 2007.
Nguyen C, Duhl AJ, Escallon CS, Blakemore KJ. "Multiple anomalies in a fetus exposed to low-dose methotrexate in the first trimester." Obstet Gynecol 2002. Jul 27 2007.
Bousvaros A, Mueller B. "Thalidomide in gastrointestinal disorders." Drugs 2001. Jul 27 2007.
Diav-Citrin O, Shechtman S, Gotteiner T, et al. "Pregnancy outcome after gestational exposure to metronidazole: a prospective controlled cohort study." Teratology May 2001. Jul 27 2007.
Caro-Patón T, Carvajal A, Martin de Diego I, Martin-Arias LH, Alvarez Requejo A, Rodríguez Pinilla E. "Is metronidazole teratogenic? A meta-analysis." Br J Clin Pharmacol. Aug 1997. Jul 27 2007.
A. Katz, Christian Antoni, Gregory F. Keenan, Deirdre E. Smith, Stephen J. Jacobs, Gary R. Lichtenstein. "Outcome of Pregnancy in Women Receiving Infliximab for the Treatment of Crohn's Disease and Rheumatoid Arthritis." The American Journal of Gastroenterology Dec 2004. Jul 27 2007.
U. Mahadevan, S. Kane, W. J. Sandborn, R. D. Cohen, K. Hanson, J. P. Terdiman, D. G. Binion. "Intentional infliximab use during pregnancy for induction or maintenance of remission in Crohn's disease." Alimentary Pharmacology & Therapeutics Mar 2005. Jul 27 2007.
Khosla R, Willoughby CP, Jewell DP. "Crohn's disease and pregnancy." Gut 1984. Jul 27 2007.
Willoughby CP, Truelove SC. "Ulcerative colitis and pregnancy." Gut 1980.
Hanan IM, Kirsner JB. "Inflammatory bowel disease in the pregnant woman." Clin Perinatol 1985. Jul 27 2007.
Nielsen OH, Andreasson B, Bondesen S, Jarnum S. "Pregnancy in ulcerative colitis." Scand J Gastroenterol 1983. Jul 27 2007.
Porter RJ, Stirrat GM. "The effects of inflammatory bowel disease on pregnancy: A case-controlled retrospective analysis." Br J Obstet Gynaecol 1986. Jul 27 2007.
Baiocco PJ, Korelitz BL. "The influence of inflammatory bowel disease and its treatment on pregnancy and fetal outcome." J Clin Gastroenterology 1984. Jul 27 2007.
Miller JP. "Inflammatory bowel disease in pregnancy: a review." J Royal Soc Med. 1986.
Bente Nørgård, M.D., Ph.D., Heidi H. Hundborg, M.Sc., Ph.D , Bent A. Jacobsen, M.D. , Gunnar L Nielsen, M.D., Kirsten Fonager, M.D., Ph.D. "Disease Activity in Pregnant Women With Crohn's Disease and Birth Outcomes: A Regional Danish Cohort Study." Am J Gastroenterol Jul 2007. 24 Jul 2007.
Peeters M, Nevens H, Baert F, et al. "Familial aggregation in Crohn's disease: Increased age, adjusted risk and concordance in clinical characteristics." Gastroenterology 1996. Jul 27 2007.
