Children Born to Mothers with Inflammatory Bowel Disease: A Review of Pediatric Outcomes

Background: Inflammatory Bowel Disease (IBD), comprising Crohn’s disease and ulcerative colitis, frequently affects women during their reproductive years. While the impact of IBD on pregnancy has been widely studied, less is known about the long-term health outcomes in children born to affected mothers, particularly in the context of in utero exposure to immunosuppressive therapies. Hypothesis: We hypothesize that children born to mothers with well-managed IBD experience normal growth and development, with minimal risk for immune-related complications, despite potential exposure to biologics and other IBD medications during gestation. Methods: A literature review was conducted using PubMed and Google Scholar. Search terms included “IBD and Fetal Health,” “Fetal Development in IBD,” “Biologics AND “pregnancy with IBD,” and “IBD and pregnancy.” Inclusion criteria focused on studies evaluating postnatal outcomes such as immune development, infection rates, growth parameters, and risk of IBD in offspring. Results: Findings from multiple cohort studies, including data from the PIANO registry, suggest that most children demonstrate normal growth and developmental trajectories. Biologic exposure, particularly to anti-TNFα agents, does not appear to significantly increase neonatal infections or immune dysfunction. While there is a modest genetic predisposition for IBD, maternal disease activity or medication use was not directly linked to pediatric disease onset. Conclusions: Children born to mothers with IBD generally have favorable long-term outcomes. Continued research is essential to further assess immune development, especially following biologic exposure in the third trimester, and to develop evidence-based pediatric follow-up guidelines.