Tu1173 Low IBD-Specific Reproductive Knowledge and Absence of Family Planning Discussion With a Physician Are Associated With Childlessness in Women With IBD

Abstract

Background Inflammatory bowel disease (IBD) affects patients in their reproductive years. Studies have shown that women with IBD often choose not to have children. This voluntary has been hypothesized to be due to patient concerns regarding possible adverse effects of their IBD and its treatment on fertility, pregnancy and the newborn. Aim The aim of the study was to correlate IBD-specific reproductive knowledge and family planning discussion with childlessness among women with IBD. Methods Female IBD patients (1845yrs) from the University of Alberta IBD clinic were consented to complete survey questions on the following: demographics; IBD and reproductive history; family planning status before/ just after IBD diagnosis and currently; IBD-specific reproductive concerns; previous family planning discussions; Crohn's and Colitis Pregnancy Knowledge (CCPKnow). CCPKnow is a validated score that ranges from poor (0-7), adequate (8-10), good (11-13), very good (14+) knowledge. The median CCPKnow score between groups was compared using nonparametric tests. Multivariate logistic regression was used to determine odds ratios (aOR, (95% CI)) for the association between CCPKnow and childlessness, adjusted for confounding variables of age and discussion of family planning. Results A total of 247 out of 408 (61% response rate) women completed the survey. The mean age was 31.8+7.7 yrs; 59.9% had Crohn's disease; 26.9% were single; 55.1% had ever been pregnant; 48.2% had biological children. The median CCPknow was 7.0 (0-16); childless women had lower CCPKnow than women who have children (6.0 vs. 8.0,p=0.002). Women were more likely to be childless if they had a lower CCPKnow (aOR 1.943 (95% CI 1.048, 3.602). Women were more likely to have poor CCPKnow if they had not discussed family planning with a physician (aOR 2.731 (95% CI 1.586, 4.703). More childless women than women with children had IBD-specific reproductive concerns (Table 1). 99/127 (78.0%) of childless women had wanted children prior to IBD diagnosis, 81/127 (63.8%) just after IBD diagnosis, and 86/126 (68.3%) currently. 19/125 (15.2%) were unsure/did not want children at all time periods. There were no differences in CCPKnow between these groups. However, childless women who were currently to become pregnant 14/126 (11.1%) had higher CCPKnow score (10.0 vs 5.0, p=0.001) than those who were not trying to become pregnant. Conclusions Women with IBD who are childless have lower IBD-specific reproductive knowledge and more IBD-specific reproductive concerns than women with IBD who have children. A lack of discussion of family planning with a physician is associated with lower IBD-specific reproductive knowledge. Therefore, physician discussion of family planning may improve patient IBD-specific reproductive knowledge, which may affect patient decisions regarding family planning.