Aiya Aboubakr1, Alexa Rae Riggs2, Darwin Jimenez3, Maria Teresa Mella4,5, Marla C Dubinsky3. 1. Icahn School of Medicine at Mount Sinai, New York, USA. 2. Department of Medicine, Susan and Leonard Feinstein IBD Clinical Center, Icahn School of Medicine, Mount Sinai, One Gustave L. Levy Place, Box 1134, New York, NY, 10029, USA. Alexa.Riggs@mssm.edu. 3. Department of Medicine, Susan and Leonard Feinstein IBD Clinical Center, Icahn School of Medicine, Mount Sinai, One Gustave L. Levy Place, Box 1134, New York, NY, 10029, USA. 4. Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine, Mount Sinai, New York, USA. 5. Division of Maternal Fetal Medicine, Icahn School of Medicine, Mount Sinai, New York, USA.
Abstract
BACKGROUND: Inflammatory bowel disease (IBD) commonly affects women of reproductive age. Many patients lacking knowledge about IBD and reproduction make uninformed decisions, such as voluntary childlessness and medication cessation. Education should be individualized to the patient's knowledge base and include topics of most importance to the patient. Our study aimed to describe the priority rankings of topics selected by patients seeking preconception and pregnancy counseling. METHODS: As part of an ongoing prospective study, patients with IBD were asked to rank, in order of importance, nine a priori preconception, pregnancy, and postpartum topics they would like addressed by our specialized care team, which includes an IBD physician and a high-risk obstetrician. χ2 and Fisher's exact tests were used to assess associations between clinical and demographic characteristics and priority rankings, and a p value cutoff for significance was set as .05. RESULTS: One hundred and fifty-eight women with IBD (mean (IQR) age; 32 (28-37) years) were seen in consultation, and 116 (70 (60%) CD, 43 (37%) UC, and 3 (3%) IBD-U) completed intake forms were analyzed. There were 78 (68%) women seen in the preconception stage, median age 31 (IQR 28-34), and 38 women (32%) were pregnant, median age 32 (IQR 28-33). Safety of IBD medications during pregnancy was most commonly ranked as top priority (40%) for all patients regardless of pregnancy status, followed by control of IBD disease activity and impact on pregnancy (31%), impact of IBD and surgery on fertility (19%), pregnancy outcomes for the baby (18%), mode of delivery (6%), inheritance of IBD (4%), breastfeeding (2%), nutritional health (2%), and vaccines and newborn care (1%). The impact of IBD and surgery on fertility was ranked as the number one priority more often in the preconception group (p value < 0.01) and mode of delivery in the pregnancy group (p value 0.04). CONCLUSION: Safety of IBD medications remains a priority topic for patients seeking preconception and pregnancy counseling.
BACKGROUND:Inflammatory bowel disease (IBD) commonly affects women of reproductive age. Many patients lacking knowledge about IBD and reproduction make uninformed decisions, such as voluntary childlessness and medication cessation. Education should be individualized to the patient's knowledge base and include topics of most importance to the patient. Our study aimed to describe the priority rankings of topics selected by patients seeking preconception and pregnancy counseling. METHODS: As part of an ongoing prospective study, patients with IBD were asked to rank, in order of importance, nine a priori preconception, pregnancy, and postpartum topics they would like addressed by our specialized care team, which includes an IBD physician and a high-risk obstetrician. χ2 and Fisher's exact tests were used to assess associations between clinical and demographic characteristics and priority rankings, and a p value cutoff for significance was set as .05. RESULTS: One hundred and fifty-eight women with IBD (mean (IQR) age; 32 (28-37) years) were seen in consultation, and 116 (70 (60%) CD, 43 (37%) UC, and 3 (3%) IBD-U) completed intake forms were analyzed. There were 78 (68%) women seen in the preconception stage, median age 31 (IQR 28-34), and 38 women (32%) were pregnant, median age 32 (IQR 28-33). Safety of IBD medications during pregnancy was most commonly ranked as top priority (40%) for all patients regardless of pregnancy status, followed by control of IBD disease activity and impact on pregnancy (31%), impact of IBD and surgery on fertility (19%), pregnancy outcomes for the baby (18%), mode of delivery (6%), inheritance of IBD (4%), breastfeeding (2%), nutritional health (2%), and vaccines and newborn care (1%). The impact of IBD and surgery on fertility was ranked as the number one priority more often in the preconception group (p value < 0.01) and mode of delivery in the pregnancy group (p value 0.04). CONCLUSION: Safety of IBD medications remains a priority topic for patients seeking preconception and pregnancy counseling.
Authors: Ariella Bar-Gil Shitrit; Yael Cohen; Ori Hassin; Ami Ben Ya'acov; Rivkah Farkash; Benjamin Koslowsky; Yael Milgrom; Dan Meir Livovsky; Arnon Samueloff; Eran Goldin; Sorina Grisaru-Granovsky Journal: Dig Dis Sci Date: 2018-04-06 Impact factor: 3.199
Authors: María Chaparro; María G Donday; Francisco Abad-Santos; Francisco Javier Martín de Carpi; Miguel Ángel Maciá-Martínez; Dolores Montero; Diana Acosta; Yanire Brenes; Javier P Gisbert Journal: Therap Adv Gastroenterol Date: 2021-06-03 Impact factor: 4.409