GuidelineAustralian inflammatory bowel disease consensusstatements for preconception,pregnancy andbreast feedingRobyn Laube,2 Christian P Selinger,3 Cynthia H Seow,4Britt Christensen Emma Flanagan,Debra Kennedy,?Reme MountifieldSean SeehoAntonia Shand,10 Astrid-Jane Williams,11Rupert W Leong 1.2.12.13For numbered affiliations seeABSTRACTtransplantation (FMT),7 use of intestinal ultra-end of article.Objective Because pregnancy outcomes tend to besounds-10 and mental health.7 Development ofworse in women with inflammatory bowel disease (IBD)these consensus statements aimed to clarify theseCorrespondence toProfessor Rupert W Leong.than in those without,we aimed to update consensusquestions.Gastroenterology and Liverstatements that guide the clinical management ofServices,Concord Repatriationpregnancy in patients with IBD.General Hospital,Concord,NewDesign A multidisciplinary working group was establishedMETHODOLOGYSouth Wales,Australia:rupertleong@outlook.comto fommulate these consensus statements.A modified RAND/A working group with expertise in IBD and preg-UCLA appropriateness method was used,consisting of anancy was established,with 16 delegates from theReceived 13 December 2022literature review,online voting,discussion meeting andfields of gastroenterology,obstetrics,maternofetalAccepted 21 February 2023a second round of voting.The overall agreement amongmedicine,genetics,colorectal surgery,general prac-the delegates and appropriateness of the statement aretice,and consumer representation.Experts fromreported.the United Kingdom and Canada were invited toResults Agreement was reached for 38/39 statementsparticipate.Delegates represented:the Gastroen-which provide guidance on management of pregnancy interological Society of Australia,The Royal Austra-patients with IBD.Most medications can and should belian and New Zealand College of Obstetricians andcontinued throughout pregnancy,except for methotrexate,Gynaecologists,The Colorectal Surgical Societyallopurinol and new small molecules,such as tofadtinib.of Australia and New Zealand,The Society ofDue to limited data,no condusion was reached on the useObstetric Medicine of Australia and New Zealand,of tioguanine during pregnancy.Acieving and maintainingThe Royal Australian College of General Practi-IBD remission before conception and throughout pregnancytioners and Crohn's and Colitis Australia.is crucial to optimise matemofetal outcomes.This requires aThe initial consensus statements were created bymultidisciplinary approach toengage patients,allay anxietiesa steering committee (RL RWL,CPS)based on theand maximise adherence tomedication.Intestinal ultrasoundPICO format(population,intervention,comparison,can be used for disease monitoring during pregnancy,andoutcomes).10 These statements were revised by aflexible sigmoidoscopy or MRI where clinically necessary.subcommittee with obstetric and patient representation.Conclusion These consensus statements provideA literature review was performed in Medl
