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BACKGROUND: There is considerable interest in improving the education and care of women with inflammatory bowel disease (IBD) to improve pregnancy outcomes. Despite increased awareness, not all women with IBD have access to pregnancy-related education and the quality of counseling is variable. We aimed to assess the effectiveness of a simple educational intervention for improving pregnancy-related knowledge and to evaluate the effect of education on patient outcomes including anxiety, depression, and quality of life in women with IBD. METHOD(S): This prospective study of women with IBD who were pregnant or planning a pregnancy evaluated the effectiveness of a single gastroenterologist-led educational intervention in improving pregnancy-related knowledge, measured using the Crohn's and Colitis Pregnancy Knowledge score 1 month postintervention. Secondary outcomes included the effect on anxiety and depression, quality of life, medication adherence, and patient satisfaction. RESULT(S): One hundred women with IBD were recruited. Fifty percent were pregnant at the time of the intervention. Baseline knowledge scores were similar independent of the patients' pregnancy status or whether they had previously received counseling from their gastroenterologist. Median Crohn's and Colitis Pregnancy Knowledge scores postintervention (n = 82) were higher than preintervention scores (14/17 vs 10/17; P < 0.001). In addition, 32% of patients had poor knowledge at baseline (score <=7/17), compared to only 5% after the intervention (P < 0.001). There was a significant improvement in total anxiety and depression and quality of life scores postintervention. Medication adherence and patient satisfaction were excellent. CONCLUSION(S): Uptake of this gastroenterologist-led educational intervention has the potential to improve pregnancy knowledge, promote medication adherence, and enhance quality of life for women with IBD globally.Copyright © 2021 Crohn's & Colitis Foundation. Published by O

Background and Aim: Ustekinumab (UST) is increasingly used in the management of inflammatory bowel disease (IBD). Although UST use during pregnancy is likely to be safe, pharmacokinetic data in pregnancy and exposed infants are limited. We aimed to establish the stability of UST levels antenatally, the ratio of infant to maternal UST levels at delivery, and the time to clearance of UST from the infant. Method(s): Women receiving UST for IBD before conception or when pregnant were prospectively recruited. Maternal trough UST levels were measured in each trimester and at delivery where possible. Infant UST levels were measured from the umbilical cord at delivery and repeated between 6 and 9 weeks of age. In infants with detectable UST levels, further testing was performed to determine time to clearance. UST levels were measured by ELISA (Theradiag). Result(s): Ten participants, all with Crohn's disease, with at least two antenatal or matched infant-maternal delivery UST levels were included. Seven participants were receiving UST every 8 weeks, one every 6 weeks, and two every 4 weeks. All were in clinical remission, but two had biochemical evidence of disease activity. No babies were born prematurely, with a median gestational age of 38.5 weeks (IQR, 38.0-39.0). The birthweight was 3246 g (2810-3480). One minor congenital heart defect was noted. Trough UST levels (mug/mL) were 2.3 (range, 1.3-2.4) in Trimester 1 (n = 3), 2.2 (IQR, 1.6-2.3) in Trimester 2 (n = 7), and 1.8 (IQR, 1.6-3.3) in Trimester 3 (n = 4), with no significant difference over the course of pregnancy (P = 0.29) (Fig. 1). The final antenatal dose was administered at Gestational Week 30 (25-33) and was 8 (5-12) weeks before delivery. Infant and non-trough maternal UST levels (mug/mL) at delivery were 4.0 (1.2-7.8) and 1.4 (0.7-4.4), respectively (n = 10), with an infant: maternal ratio of 1.8 (1.4-2.6). There was a positive correlation between maternal and infant delivery levels (R = 0.76, P = 0.01). T