Knowledge and Beliefs about Pregnancy Issues among Women with Inflammatory Bowel Disease in Reproductive Age

Introduction: Inflammatory bowel disease (IBD) affects women in reproductive age. Knowledge level and beliefs about pregnancy issues need to be assessed among women who desire to become pregnant. Purpose: The purpose of this study was to investigate the knowledge and beliefs of women in reproductive age who suffer from IBD in reproductive issues. Material and Method: The study was conducted from February to September 2016 with convenience sampling at a hospital of Athens. The study included from 82 women. 54.9% of patients suffered from Crohn's disease, and 45.1% from ulcerative colitis. Disease-related pregnancy knowledge was assessed using Crohn's and Colitis Pregnancy Knowledge Score (CCPKnow) and pregnancy beliefs with a structured tool consisting of 23 questions suitably formed for the purpose of this study. Τ-test and anova were performed and the level of statistical significance was set at p-value≤0.05. Results: Knowledge levels were low, adequate, good and very good at 63.4%, 22%, 11% and 3.7% respectively. The main knowledge deficient referred to fertility statements with 64.7% answering incorrectly to all questions. About 41.5% of the participants answered correctly at least 2 of the 5 medication related questions and 40.2% were ignorant about disease inheritance. Highest CCPKnow scores were associated with higher education level (tertiary 7.37 vs secondary 5.08, p <0.05) and use of biological agents (6.86 vs 4.69, p <0.05). About 60,9% disagreed with the statement that a woman was less probably to conceive because of IBD. High percentage believed that it is important to get any medication if she has a flare when she is trying to become pregnant or when she is pregnant (75.5%, 78% respectively). 59.7% believed that medications which maintain remission should be continued during pregnancy. About 64.6% of women stated that breast feeding should be avoided under specific medications. Over 80% seemed to be worried about the effect of IBD on pregnancy and inheritance of disease. Lower CCPKnow scores correlated with beliefs that a woman should stop all medication or every IBD medication when she tries to get pregnant, or endure the symptoms to protect the unborn, and also with belief that breast feeding is forbidden even if woman does not take any IBD medication (p<0,05). Conclusions: Most participants had poor knowledge level on IBD pregnancy-related issues. Beliefs about pregnancy influenced the overall knowledge score. Educating women of childbearing age may alleviate the lack of knowledge and beliefs of women who wish to be pregnant.