Good news for pregnant IBD patients: a new meta-analysis confirms that biologic therapies — including anti-TNF blockers, vedolizumab, and ustekinumab — are generally safe to continue during pregnancy. Anti-TNF blockers showed the most favorable profile for disease control, while vedolizumab carried a slightly higher risk of preterm birth. Experts stress that treatment decisions should still be individualized for each patient.
Managing inflammatory bowel disease (IBD) during pregnancy just got clearer. A new meta-analysis published in Digestive Diseases and Sciences reviewed 9 observational studies involving over 6,000 pregnant women and found that biologic therapies — anti-TNF blockers, vedolizumab, and ustekinumab — are broadly safe to continue during pregnancy, reinforcing current clinical guidelines.
Anti-TNF blockers emerged as the top performer, showing the best balance of disease control and safety. Vedolizumab was linked to higher rates of preterm birth and active IBD compared to anti-TNF blockers, while ustekinumab was associated with a higher risk of congenital abnormalities versus anti-TNF therapy. That said, no significant differences were found across all three agents for spontaneous abortion, live birth, or postnatal infections.
Key Takeaways:
Why it matters: Women with IBD already face elevated risks of preterm birth and fetal complications — especially when disease is poorly controlled. This study gives clinicians stronger evidence to keep patients on biologic therapy through pregnancy, while helping guide which agent may be the safest choice.
