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P586. Assessment of pregnancy-specific inflammatory bowel disease (IBD) knowledge, attitudes and experience in Australian obstetricians and gynaecologists (O&G)

M. Roberts1, C. Selinger2, R. Leong3, J. Andrews4, 1Royal Adelaide Hospital, Adelaide, Australia, 2University of Manchester, School of Translational Medicine, Manchester, United Kingdom, 3Concord Hospital and University of Sydney, Department of Gastroenterology and Hepatology, Sydney, Australia, 4Royal Adelaide Hospital and University of Adelaide, Department of Gastroenterology and Hepatology, Adelaide, Australia

Background

Patients with IBD have higher levels of anxiety regarding pregnancy and reproduction along with lower reproduction rates, which appear to be voluntary. The basis for this “voluntary childlessness” is largely unknown and may relate to exaggerated concerns and adverse information received by IBD patients. As patients are likely to receive much pregnancy-specific information from O&Gs, we sought to investigate their knowledge and experiences of, as well as attitudes and comfort towards IBD and pregnancy.

Methods

A recently validated questionnaire of pregnancy-specific IBD knowledge (CCPKnow) was mailed to South Australian O&Gs listed on the Royal Australian and New Zealand College of Obstetricians and Gynaecologists public registry. In addition, self-reported clinical experiences with, and comfort and attitudes towards IBD management were assessed.

Results

The questionnaire and survey were sent to 94 O&Gs, 52 replied (55.3%), 35 of whom completed the CCPKnow and survey (37.1%). CCPKnow scores ranged from 8–17/17. (Mean 13.1, Median 15, Mode 14). Questions regarding medication were most commonly answered incorrectly, with 25/35 (71.4%) unsure of best practice regarding biological agents. O&Gs with <15 years as a consultant had a mean CCPKnow score of 13.9 (n = 15), compared to 12.5 (n = 20) for their more experienced O&Gs (p value <0.05). O&Gs who had managed <5 patients with IBD in the last 5 years had a mean score of 11.3 (n = 24), compared with 14.0 (n = 11) in those with a greater clinical load of IBD patients (p value <0.03). O&Gs indicated they were 3 times more likely to seek input from a “local gastroenterologist” (n = 24) than from an IBD specialist service (n = 8). Self reported “comfort” in managing IBD patients was not associated with a higher mean CCPKnow score (13.8 for the 19 reporting “comfort” vs. 13.1 – whole sample).

Conclusion

O&Gs have a wide range of knowledge and varied experience in dealing with patients with IBD and pregnancy specific issues. Overall scores are low, and lower than those previously shown in IBD nurses. Comfort did not correlate with better knowledge. The key role of gastroenterologists as a resource to O&Gs is highlighted, however, as biological agents become more common, IBD specialists may be a more appropriate resource group, particularly as O&G knowledge of biologicals is poor. This study suggests that IBD patients getting pregnancy information predominantly from their O&Gs are likely to be receiving some misinformation.