P35 Managing inflammatory bowel disease in pregnancy: healthcare professionals’ involvement, knowledge and decision-making

Abstract

<h3>Introduction</h3> The management of pregnant women with inflammatory bowel disease (IBD) is complex. We aimed to assess healthcare professionals’ (HCP) theoretical and applied knowledge of pregnancy-related IBD issues. <h3>Methods</h3> A cross-sectional international survey was distributed to HCPs providing IBD care between October 2020 and March 2021. Knowledge was assessed using the validated Crohn’s and Colitis Pregnancy Knowledge Score (CCPKnow; range 0 – 17). Decision-making was assessed by free text responses to 3 clinical scenarios scored against pre-determined scoring criteria (total maximum score 70). <h3>Results</h3> Among 81 participants, 34 (42%) reported having a specialist team managing pregnant women with IBD, and 15 (18.5%) were part of that team. Median CCPKnow score was 16/17 (range 8 to 17) and median total scenario score was 29/70 (range 9 to 51). While CCPKnow scoring was consistently high (median score ≥15) across all groups, consultants scored better than trainees and IBD nurses (p=0.008 and p=0.031). Median scenario scores were higher for consultants (32) and IBD nurses (33) compared to trainees (24; p=0.018 and p=0.022). Median scenario score for HCPs never involved in the care of pregnant IBD patients (n=7; 8.6%) was 17, very little involvement (n=27; 33.3%) 26, occasional involvement (n=21; 25.9%) 29, and regular involvement (n=26; 32.1%) 35. HCPs who treat more than 10 IBD patients per week (CCPKnow p=0.03; scenarios p=0.003) and are more regularly involved in pregnancy care (CCPKnow p=0.005; scenarios p=0.005) had significantly better scores. There was a significant positive correlation between caring for greater numbers of pregnant IBD patients and higher CCPKnow (p=0.001, r=0.358) and scenario scores (p=0.001, r=0.377). While there was significant correlation between CCPKnow and scenario scores, the effect was modest (r=0.356; p&lt;0.001). Self-rated knowledge (CCPKnow p&lt;0.001, r=0.416; scenarios p=0.002, r=0.340) and self-rated comfort in treating pregnant women (CCPKnow p&lt;0.001, r=0.404; scenarios p&lt;0.001, r=0.374) correlated modestly with CCPKnow and scenario scores. <h3>Conclusions</h3> CCPKnow scores were generally high among HCPs with small differences in scores while we found significant variations in scenario scores. Despite “good” theoretical pregnancy-related IBD knowledge as assessed by CCPKnow, applied knowledge in the scenarios was less consistent. There is need for further HCP education and clinical experience to achieve optimal standardised care for IBD in pregnancy.