Factors Influencing IBD Risk in Offspring of Mothers wiht Inflammatory Bowel Disease
Recent research highlights several key risk factors and environmental influences impacting the development of Inflammatory Bowel Disease (IBD) in children born to mothers with the condition. A global consensus statement emphasizes the need for proactive management, starting well before conception.
Genetic Predisposition & Family History
A strong familial link to IBD is evident. A Danish study demonstrated a significantly increased hazard ratio (HR) of 4.6 for offspring developing ulcerative colitis (UC) if their mothers had UC, compared to those without IBD. The risk was even higher with Crohn’s disease (CD), showing an HR of 7.7 for IBD development in children of mothers with CD.
Potential links to Placental Function & Lifestyle Factors
While research suggests IBD is unlikely to directly impair placental development due to the organ’s critical role in pregnancy, other factors are under examination. Smoking during pregnancy has been associated with a 1.5 increased odds ratio (OR) for IBD in offspring, as shown in a meta-analysis of nine studies and corroborated by population-based cohort research. Similarly, prenatal antibiotic use is linked to a 1.75 OR for IBD in children. Notably, very-early-onset IBD showed an adjusted HR of 1.93, with CD being a stronger contributor to this risk than UC.
Environmental factors & Maternal Influence
Investigators observed a higher incidence of IBD in offspring when the mother, rather than the father, had the condition, suggesting early environmental triggers play a role. Maternal diet during pregnancy is being explored as a potential factor, with increased food additive (FA) intake reported in mothers with IBD compared to those without. Increased fecal calprotectin levels – an indicator of gut inflammation – were found in infants born to mothers with higher FA intake, regardless of their IBD status, supporting the idea that prenatal diet can influence offspring gut health.
The maternal microbiome is also under scrutiny. The only current human study with significant evidence demonstrates that mothers with prenatal IBD exhibit altered gut microbiota composition during pregnancy, impacting the bacterial diversity and abundance in their offspring. This has spurred research, including the Modulating Early Life Microbiome through Dietary Intervention in Pregnancy trial, focused on preventing intestinal inflammation in offspring by modifying the maternal microbiome.However, long-term follow-up is crucial to assess the trial’s effectiveness.
Recommendations & Future Directions
Based on this accumulating evidence, investigators strongly advocate for preconception counseling. this counseling,ideally conducted at least six months before attempting conception – and initiated at the time of IBD diagnosis for women of reproductive age – shoudl be led by an IBD care provider.
“We hope that this consensus statement will provide a blueprint for evidence-based management of women with IBD, from pre-conception to post-delivery,” stated Dr. Millie D. Long of the University of North Carolina, co-chair of the Global Consensus Conference.
References:
- Frist global guidelines for pregnancy and inflammatory bowel disease developed. University of California San Francisco Medical Center. August 28, 2025. Accessed September 2, 2025.https://www.eurekalert.org/news-releases/1096189.
- Mahadevan U, Seow CH, Barned EL, et al. Global consensus statement on the management of pregnancy in inflammatory bowel disease. Clinical Gastroenterology and Hepatology. 2025. doi:10.1016/j.cgh.2025.04.005
