Millie Long, MD, MPH, Chief of the Division of Gastroenterology and Hepatology at UNC-Chapel Hill, and Edward Barnes, MD, MPH, Co-Director of the UNC Multidisciplinary IBD Center, played key roles in developing the first international guidelines for managing inflammatory bowel disease (IBD) during pregnancy, along with Uma Mahadevan, MD, PI and director of the Colitis and Crohn’s Disease Center at UCSF.
Published simultaneously in six major journals, the Helmsley PIANO Global Consensus offers evidence-based recommendations to improve outcomes for pregnant individuals with IBD and their children. The guidelines are based on findings from the PIANO study, which followed over 2,200 pregnant patients with IBD. Their new guidelines reflect a collaborative effort of over 50 international experts, with UNC faculty at the forefront of shaping care for women with IBD worldwide.
“A unique aspect of this consensus conference was the geographically diverse representation from around the globe,” said Millie D. Long MD, MPH, co-chair of the Global Consensus Conference ,“Through this international collaboration, we ensured that all recommendations were feasible and appropriate for women with IBD. In addition, we included patient representatives from each continent to maximize the role of the patient voice in determining best practices of care. We hope that this consensus statement will provide a blueprint for evidence-based management of women with IBD, from pre-conception to post-delivery.”
The final study results and guidelines include new findings such as continuing all biologics throughout pregnancy and lactation, universal pre-conception counseling, understanding of high-risk maternal status, providing low dose aspirin to prevent preterm preeclampsia, and giving the rotavirus vaccine on schedule.
“Some of the findings were expected, but others were novel,” said Uma Mahadevan, MD, director of the Colitis and Crohn’s Disease Center at UCSF, principal investigator of the PIANO study, and chair of the Global Consensus Conference. “The goal of our study and consortium has been to provide hope, comfort, and the same high-level care to current and future mothers with IBD. The consensus recommendations are the first truly global effort to improve treatment and outcomes for women with IBD and their children.”