Risk Factors for Contraceptive Failure and Unintended Pregnancy Among Women With Inflammatory Bowel Disease. Erica J Brenner, MD, MSCR, Xian Zhang, PhD, Uma Mahadevan, MD, Amy G Bryant, MD, MSCR, Michael D Kappelman, MD, MPH, Millie D Long, MD, MPH
Among pregnant women with IBD, risk factors for unplanned pregnancy from contraceptive failure included low socioeconomic status, low education level, no domestic partner, and racial/ethnic minority status. Active disease and corticosteroid use were not uncommon among those with unplanned pregnancy.

Placental Transfer of Upadacitinib Among Pregnant Women with Inflammatory Bowel Disease. Ehrlich S, Long M, Kane S, Mahadevan U.Inflamm Bowel Dis. 2025 Feb 21:izaf027. doi: 10.1093/ibd/izaf027. Online ahead of print.PMID: 39982830 No abstract available.
Upadacitinib (Rinvoq) is a pill taken for UC and CD. This study shows that drug does cross the placenta and is detectable in infant blood, but at lower levels than in the mother – unlike the biologics which generally have higher levels in baby than mom.

The Effect of Low-Dose Aspirin on Disease Activity in Pregnant Individuals With Inflammatory Bowel Disease. Memel Z, Yu A, Fenton C, Wen T, Irani RA, Zhang L, Mahadevan U.Am J Gastroenterol. 2025 Jan 7. doi: 10.14309/ajg.0000000000003304. Online ahead of print.PMID: 39773571
Women with IBD have higher rates of pre-eclampsia. Studies have shown that low dose aspirin (150 mg daily), started between weeks 12-16 of pregnancy and taken until at least 36 weeks of pregnancy, reduces this risk. It is recommended that women with IBD take low dose aspirin during pregnancy. This study shows that it does not result in an increase in IBD disease flare.

Maternal and Neonatal Outcomes in Vedolizumab- and Ustekinumab-Exposed Pregnancies: Results From the PIANO Registry. Chugh R, Long MD, Jiang Y, Weaver KN, Beaulieu DB, Scherl EJ, Mahadevan U. Am J Gastroenterol. 2024 Mar 1;119(3):468-476. doi: 10.14309/ajg.0000000000002553. Epub 2023 Oct 5.PMID: 37796648
Monoclonal antibodies like infliximab, adalimumab and certolizumab are not associated with an increase in adverse outcomes for the baby if the mother takes it during pregnancy. This study looks at the newer biologics, ustekinumab (Stelara) and vedolizumab (Entyvio) and shows that they are also not associated with bad outcomes. There is some placental transfer of drug with levels detected in the infant.

Low Placental Transfer Rates of Risankizumab Among Pregnant Women With Inflammatory Bowel Disease. Mahadevan U, Long M.Inflamm Bowel Dis. 2024 Nov 4;30(11):2240-2241. doi: 10.1093/ibd/izae182.
Risankizumab (Skyrizi) is approved for use in Crohn’s disease and ulcerative colitis. It is in a similar class to ustekinumab (Stelara). This brief report shows that risankizumab does cross the placenta and the baby is born with detectable levels, but less than in the mother. There has been no harm reported for Stelara (more data) or Skyrizi to date from maternal exposure to these drugs.

Use of Biosimilars to Infliximab During Pregnancy in Women With Inflammatory Bowel Disease: Results From the Pregnancy in Inflammatory Bowel Disease and Neonatal Outcomes Study. Long MD, Kane S, Beaulieu D, Abraham B, Zhang X, Mahadevan U.Clin Transl Gastroenterol. 2024 Dec 1;15(12):e00795. doi: 10.14309/ctg.0000000000000795.
Biosimilars for Remicade, humira and now Stelara are on the market and many patients are switched. No adverse events are expected in pregnancy and none were seen in this small series from PIANO. Most European studies just look at "infliximab" and not at brand, and have not shown adverse events.

Wound Healing After Vaginal Delivery, Episiotomy, and Cesarean Section Delivery Among Women With IBD: Results From the PIANO Registry. Lewin S, Long M, Cohen R, Scherl E, Wolf D, Mahadevan U.Inflamm Bowel Dis. 2025 Jan 8:izae310. doi: 10.1093/ibd/izae310. Online ahead of print.PMID: 39779464
Episiotomy was a common in patients with IBD. Azathioprine/6mp, but not biologic, use was found to be associated with delayed wound healing. Vaginal tears were also common but delayed wound healing was not associated with IBD therapy. C-section occurred at high rates, particularly in Crohn's disease patients, with no reported delays in postpartum wound healing.

Exposure to corticosteroids in pregnancy is associated with adverse perinatal outcomes among infants of mothers with inflammatory bowel disease: results from the PIANO registry. Odufalu FD, Long M, Lin K, Mahadevan U; PIANO Investigators from the Crohn's and Colitis Foundation (CCF) Clinical Research Alliance recruited patients for their respective centers for participant enrollment.Gut. 2022 Sep;71(9):1766-1772. doi: 10.1136/gutjnl-2021-325317

Vedolizumab Antagonizes MAdCAM-1-Dependent Human Placental Cytotrophoblast Adhesion and Invasion In Vitro. Blaisdell A, Zhou Y, Kattah MG, Fisher SJ, Mahadevan U.Inflamm Bowel Dis. 2022 Aug 1;28(8):1219-1228

Day Care Attendance and Infectious Complications in Children Born to Mothers With Inflammatory Bowel Disease. Long MD, Siegel CA, Abraham BP, Chiorean M, Mahadevan U. Clin Gastroenterol Hepatol. 2022 Mar;20(3):706-708


Infliximab Use in a Child With Ulcerative Colitis and Prior In Utero Exposure to Infliximab. Lim J, Hammami MB, Mahadevan U.Gastroenterology. 2020 May;158(6):1834-1835

Safety of Flexible Sigmoidoscopy in Pregnant Patients with Known or Suspected Inflammatory Bowel Disease. Ko MS, Rudrapatna VA, Avila P, Mahadevan U.Dig Dis Sci. 2020 Oct;65(10):2979-2985

Preventive Health Care Among Postpartum Women With Inflammatory Bowel Disease: Results From the PIANO Registry. Mao EJ, Sheibani S, Martin C, Bloomfeld RS, Isaacs K, Saha S, Mahadevan U.Inflamm Bowel Dis. 2019 Mar 14;25(4):797-80

Inflammatory Bowel Disease in Pregnancy Clinical Care Pathway: A Report From the American Gastroenterological Association IBD Parenthood Project Working Group. Mahadevan U, Robinson C, Bernasko N, Boland B, Chambers C, Dubinsky M, Friedman S, Kane S, Manthey J, Sauberan J, Stone J, Jain R.Gastroenterology. 2019 Apr;156(5):1508-1524.

Exposure Concentrations of Infants Breastfed by Women Receiving Biologic Therapies for Inflammatory Bowel Diseases and Effects of Breastfeeding on Infections and Development. Matro R, Martin CF, Wolf D, Shah SA, Mahadevan U.Gastroenterology. 2018 Sep;155(3):696-704.

Anti-TNF and thiopurine therapy in pregnant IBD patients does not significantly alter a panel of B-cell and T-cell subsets in 1-year-old infants. Kattah MG, Milush JM, Burt T, McCabe RP Jr, Whang MI, Ma A, Mahadevan U.Clin Transl Gastroenterol. 2018 Apr 3;9(4):143.

Use of Biologic Therapy by Pregnant Women With Inflammatory Bowel Disease Does Not Affect Infant Response to Vaccines. Beaulieu DB, Ananthakrishnan AN, Martin C, Cohen RD, Kane SV, Mahadevan U.Clin Gastroenterol Hepatol. 2018 Jan;16(1):99-105. doi: 10.1016/j.cgh.2017.08.041

Inadequate Gestational Weight Gain Predicts Adverse Pregnancy Outcomes in Mothers with Inflammatory Bowel Disease: Results from a Prospective US Pregnancy Cohort. Bengtson MB, Martin CF, Aamodt G, Vatn MH, Mahadevan U.Dig Dis Sci. 2017 Aug;62(8):2063-2069

Inadequate Gestational Weight Gain, the Hidden Link Between Maternal IBD and Adverse Pregnancy Outcomes: Results from the Norwegian Mother and Child Cohort Study. Bengtson MB, Aamodt G, Mahadevan U, Vatn MH.Inflamm Bowel Dis. 2017 Jul;23(7):1225-1233

Vertical Transmission of Histoplasmosis Associated With Anti-Tumor Necrosis Factor Therapy. Carlucci JG, Halasa N, Creech CB, Dulek DE, Gómez-Duarte OG, Nelson GE, Talbot HK, Scalise ML, Scott PL, Mahadevan U, Beaulieu DB.J Pediatric Infect Dis Soc. 2016 Jun;5(2):e9-e12

Placental transfer of anti-tumor necrosis factor agents in pregnant patients with inflammatory bowel disease. Mahadevan U, Wolf DC, Dubinsky M, Cortot A, Lee SD, Siegel CA, Ullman T, Glover S, Valentine JF, Rubin DT, Miller J, Abreu MT.Clin Gastroenterol Hepatol. 2013 Mar;11(3):286-92;


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