Robyn Laube1,2, Yunki Yau1, Christian P Selinger3, Cynthia H Seow4, Amanda Thomas1, Sai Wei Chuah5, Ida Hilmi6, Ren Mao7,8, David Ong9, Siew C Ng10, Shu Chen Wei11, Rupa Banerjee12, Vineet Ahuja13, Othman Alharbi14, Rupert W Leong1. 1. Department of Gastroenterology and Hepatology, Concord Repatriation General Hospital, Sydney, Australia. 2. Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia. 3. Department of Gastroenterology, Leeds Teaching Hospitals NHS Trust, Leeds, UK. 4. Division of Gastroenterology and Hepatology, Department of Medicine, University of Calgary, Alberta, Canada. 5. Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore. 6. Division of Gastroenterology and Director of Endoscopy, University of Malaya Medical Centre, Kuala Lumpur, Malaysia. 7. Department of Gastroenterology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China. 8. Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Ohio, USA. 9. Division of Gastroenterology and Hepatology, National University Hospital System, Singapore. 10. Department of Medicine and Therapeutics, Institute of Digestive Disease, State Key Laboratory of Digestive Diseases, Li Ka Shing Institute of Health Science, The Chinese University of Hong Kong, Hong Kong, China. 11. Department of Internal Medicine, National Taiwan University Hospital, Taiwan. 12. Department of Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India. 13. Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi, India. 14. King Saud University, College of Medicine, King Khalid University Hospital, Riyadh, Saudi Arabia.
Abstract
BACKGROUND AND AIMS: Poor knowledge of inflammatory bowel disease [IBD] in pregnancy underlies unwarranted voluntary childlessness [VC], and risks poorer obstetric outcomes and adverse fetal outcomes. IBD is increasing worldwide but education on IBD issues might be heterogeneous based on cultural differences and variations in models of care. METHODS: Consecutive female IBD subjects aged 18-45 years were prospectively recruited from two dedicated IBD-pregnancy clinics, two multidisciplinary IBD clinics and nine general gastroenterology clinics. Subjects completed the validated CCPKnow [score 0-17] with questions on demographics, medical history and pregnancy knowledge. The primary outcome was knowledge per clinic-type and per geographical region. RESULTS: Surveys were completed by 717 subjects from 13 hospitals across ten countries. Dedicated IBD-pregnancy clinics had the highest knowledge, followed by multidisciplinary IBD clinics then general IBD clinics (median CCPKnow 10.0 [IQR: 8.0-11.0], 8.0 [IQR: 5.0-10.5] and 4.0 [IQR:2.0-6.0]; p < 0.001). Median CCPKnow scores in Western, Asian and Middle Eastern clinics were 9.0, 5.0 and 3.0 respectively [p < 0.001]. Dedicated IBD-pregnancy clinics, IBD support organization membership, childbearing after IBD diagnosis and employment independently predicted greater knowledge. Patient perception of disease severity [r = -0.18, p < 0.01] and consideration of VC [r = -0.89, p = 0.031] negatively correlated with CCPKnow score. The overall VC rate was 15.0% [95% CI: 12.2-18.2]. VC subjects had significantly lower pregnancy-specific IBD knowledge than non-VC subjects (median CCPKnow 4.0 [IQR: 2.0-6.0] and 6.0 [IQR: 3.0-9.0] respectively; p < 0.001). Pregnancy-specific IBD knowledge and dedicated IBD-pregnancy clinic attendance were significant negative predictors of VC. CONCLUSIONS: In this large international study we identified predictors of pregnancy-specific IBD knowledge. Dedicated IBD-pregnancy clinics had the greatest IBD-related pregnancy knowledge and lowest VC rates, reflecting the benefits of pre-conception counselling.
BACKGROUND AND AIMS: Poor knowledge of inflammatory bowel disease [IBD] in pregnancy underlies unwarranted voluntary childlessness [VC], and risks poorer obstetric outcomes and adverse fetal outcomes. IBD is increasing worldwide but education on IBD issues might be heterogeneous based on cultural differences and variations in models of care. METHODS: Consecutive female IBD subjects aged 18-45 years were prospectively recruited from two dedicated IBD-pregnancy clinics, two multidisciplinary IBD clinics and nine general gastroenterology clinics. Subjects completed the validated CCPKnow [score 0-17] with questions on demographics, medical history and pregnancy knowledge. The primary outcome was knowledge per clinic-type and per geographical region. RESULTS: Surveys were completed by 717 subjects from 13 hospitals across ten countries. Dedicated IBD-pregnancy clinics had the highest knowledge, followed by multidisciplinary IBD clinics then general IBD clinics (median CCPKnow 10.0 [IQR: 8.0-11.0], 8.0 [IQR: 5.0-10.5] and 4.0 [IQR:2.0-6.0]; p < 0.001). Median CCPKnow scores in Western, Asian and Middle Eastern clinics were 9.0, 5.0 and 3.0 respectively [p < 0.001]. Dedicated IBD-pregnancy clinics, IBD support organization membership, childbearing after IBD diagnosis and employment independently predicted greater knowledge. Patient perception of disease severity [r = -0.18, p < 0.01] and consideration of VC [r = -0.89, p = 0.031] negatively correlated with CCPKnow score. The overall VC rate was 15.0% [95% CI: 12.2-18.2]. VC subjects had significantly lower pregnancy-specific IBD knowledge than non-VC subjects (median CCPKnow 4.0 [IQR: 2.0-6.0] and 6.0 [IQR: 3.0-9.0] respectively; p < 0.001). Pregnancy-specific IBD knowledge and dedicated IBD-pregnancy clinic attendance were significant negative predictors of VC. CONCLUSIONS: In this large international study we identified predictors of pregnancy-specific IBD knowledge. Dedicated IBD-pregnancy clinics had the greatest IBD-related pregnancy knowledge and lowest VC rates, reflecting the benefits of pre-conception counselling.
Authors: L A C Admiraal; A N Rosman; R J E M Dolhain; R L West; A G M G J Mulders Journal: BMC Pregnancy Childbirth Date: 2022-03-23 Impact factor: 3.007