S3208 Knowledge Deficit Surrounding Pregnancy in the Setting of Inflammatory Bowel Disease May Explain Increase in Childlessness Among IBD Patients

Abstract

INTRODUCTION: With 1.6 million inflammatory bowel disease (IBD) diagnoses in the United States (US), the vast majority are in persons during their reproductive years. Compared to 6% of women in the general population, 17% of women with IBD remain voluntarily childless. A hypothesis for this difference lies in the lack of education around pregnancy while managing IBD. This may be rooted in a fear of the effect IBD or its medications would have on conception and pregnancy or vice versa. Herein, we aim to evaluate the pregnancy-related knowledge of women and men with IBD in a single-center US population. METHODS: A total of 43 persons (21 male and 22 female) with IBD, from a US based population were administered a questionnaire comprising 17 questions from a previously validated Crohn's and Colitis Pregnancy Knowledge Score (CCPKnow). Scores of 0–7, 8–10, 11–13, and ≥14, were categorized as: “poor”, “adequate”, “good”, and “very good” levels of disease related knowledge. Statistical analysis was performed using R. For univariate analyses, differences in continuous mean scores of CCPKnow were analyzed by demographic data and explanatory measures (Figure 1) using independent t-tests for normally distributed data, Mann-Whitney U test for skewed data and ANOVA for multi-level variables. Univariate and multivariate analyses was conducted under a Gaussian distribution. RESULTS: Knowledge scores ranged from 0 to 14. Thirty-one (72.1%) respondents scored “poor,” 9 (20.9%) scored “adequate,” 2 (4.7%) scored “good,” and 1 (2.3%) scored “very good” (Figure 2). Women scored significantly better than men (mean CCPKnow score 6.2 vs. 3.4, P < 0.01). ANOVA analysis revealed decreasing knowledge scores post-IBD diagnosis (P = 0.01). Univariate linear regression analyses revealed that female gender (Beta = 2.80, P = 0.02), part-time employment status (Beta = 3.26, P = 0.03), years’ post-diagnosis (Beta = 8.00, P < 0.01), and pre-conception counseling on the effects of IBD-related medications (Beta = 3.32, P < 0.01) were significantly, independently associated with better knowledge scores. Upon multivariate analysis, knowledge scores significantly decreased 6–10 years post-diagnosis (Beta = -5.50, P = 0.01). CONCLUSION: As 72.1% of patients were categorized as having “poor” disease related knowledge, the need for targeted patient education on this subject is paramount. Thus, a lack of disease-related knowledge may be contributing to the higher rate of childlessness among IBD patients.Figure 1.: Patient Characteristics and Crohn's and Colitis Pregnancy Knowledge (CCPKnow) scores.Figure 2.: Crohn's and Colitis Pregnancy Knowledge (CCPKnow) score range and knowledge level.