Inflammatory bowel disease and pregnancy: Lack of knowledge is associated with negative views
- 1 July 2013
- journal article
- Published by Oxford University Press (OUP) in Journal of Crohn's and Colitis
- Vol. 7 (6), e206-e213
- https://doi.org/10.1016/j.crohns.2012.09.010
Abstract
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. 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'. 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. 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.Keywords
This publication has 13 references indexed in Scilit:
- Patients' knowledge of pregnancy‐related issues in inflammatory bowel disease and validation of a novel assessment tool (‘CCPKnow’)Alimentary Pharmacology & Therapeutics, 2012
- Clinical impact and drivers of non-adherence to maintenance medication for inflammatory bowel diseaseExpert Opinion on Drug Safety, 2011
- Anxiety and depression in patients with inflammatory bowel diseaseInflammatory Bowel Diseases, 2011
- Self‐reported antenatal adherence to medical treatment among pregnant women with Crohn’s diseaseAlimentary Pharmacology & Therapeutics, 2010
- Pregnancy and IBD treatment: This challenging interplay from a patients' perspectiveJournal of Crohn's and Colitis, 2010
- Patientsʼ attitudes to medicines and adherence to maintenance treatment in inflammatory bowel diseaseInflammatory Bowel Diseases, 2009
- Fear and fertility in inflammatory bowel disease: A mismatch of perception and reality affects family planning decisionsInflammatory Bowel Diseases, 2009
- Voluntary childlessness is increased in women with inflammatory bowel diseaseInflammatory Bowel Diseases, 2007
- Pregnancy before and after the diagnosis of inflammatory bowel diseases: Retrospective case–control studyJournal of Gastroenterology and Hepatology, 2007
- American Gastroenterological Association Institute Medical Position Statement on the Use of Gastrointestinal Medications in PregnancyGastroenterology, 2006