Inflammatory bowel disease and pregnancy

lack of knowledge is associated with negative views

Christian P. Selinger*, Jayne Eaden, Warwick Selby, D. Brian Jones, Peter Katelaris, Grace Chapman, Charles McDondald, John McLaughlin, Rupert W L Leong, Simon Lal

*Corresponding author for this work

Research output: Contribution to journalArticle

81 Citations (Scopus)

Abstract

Background: Enabling women with inflammatory bowel diseases (IBD) to have successful pregnancies requires complex decisions. The study aimed to assess patients' views on IBD and pregnancy and to evaluate any association with subject knowledge. Methods: General attitudes of females with IBD were assessed on fertility, medication use, delivery mode and pregnancy outcomes. Attitudes regarding personal situation were assessed in participants nulliparous since IBD diagnosis. Knowledge of pregnancy-related issues in IBD was assessed by the Crohn's and Colitis Pregnancy Knowledge Score 'CCPKnow'. Results: Of 145 participants 68% of participants agreed with need for medical therapy for flares during pregnancy, but 24% felt it more important to tolerate symptoms. 36% believed that all IBD medication is harmful to unborn children. Of 96 women nulliparous after IBD diagnosis, 46% were worried about infertility, 75% expressed concern about passing IBD to offspring and 30% considered not having children. Nearly all participants worried about the effects of IBD on pregnancy and the effects of pregnancy on IBD. General attitudes that 'medication should be stopped prior to conception' (P. <0.001), 'pregnant women should avoid all IBD drugs' (P. <0.001), and 'put up with symptoms' (P. <0.001) were associated with significantly lower CCPKnow scores. Conclusion: Over a third of patients considered IBD medication harmful to unborn children. Fear of infertility and concerns about inheritance may explain high rates of voluntary childlessness. Attitudes contrary to medical evidence were associated with significantly lower knowledge. Young women with IBD, particularly those with poor knowledge, should be offered education and counselling about pregnancy-related issues.

Original languageEnglish
Pages (from-to)e206-e213
Number of pages8
JournalJournal of Crohn's and Colitis
Volume7
Issue number6
DOIs
Publication statusPublished - 1 Jul 2013

Keywords

  • Attitudes
  • Patient knowledge
  • Pregnancy

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