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P334 Level of education and knowledge about female health issues in patients with inflammatory bowel disease.

S. Chetcuti Zammit1, M. Caruana1, K.H. Katsanos2, G.J. Mantzaris3, M. Cesarini4, U. Kopylov5, L. Zammit1, P. Ellul*1

1Mater Dei Hospital, Department of Gastroenterology, Msida, Malta, 2University of Ioannina School of Medical Sciences, Department of Internal Medicine, Medical School, Ioannina, Greece, 3Evangelismos, Ophthalmiatreion Athinon and Polyclinic Hospitals, Department of Gastroenterology, Athens, Greece, 4Sapienza University of Rome, Dipartimento di Medicina Interna e Specialità' Mediche, Rome, Italy, 5Sheba Medical Center, Department of Gastroenterology, Tel Hashomer, Israel


Female health issues such as fertility, breastfeeding, pregnancies, HPV vaccination and cervical cancer screening can be causes of concern and anxiety in inflammatory bowel disease (IBD) patients. The aim of this study was to assess the patient's knowledge about these issues.

Level of EducationPercantage
Primary School03.4%
Secondary School20.2%
High school / sixth form / college or equivalent39.1%
Trade / technical / vocational training04.7%
University degree04.7%
Post-graduate degree03.9%


This was a prospective study were patients were recruited from 5 European centres. Female IBD patients were recruited and they were interviewed through a purposely designed questionnaire.


233 patients were recruited (mean age 40 SD±11.9). The mean age of diagnosis of IBD was 31.35 years (range 4 - 65 years; SD±11.2).

43.3% of pregnancies were planned. A younger age at diagnosis was associated with a higher number of pregnancies (p<0.006).

Only 57.9% of patients were counseled by health care professionals on IBD and fertility. This was done by gastroenterologists (46.8%) and gynaecologists (7.30%). Considering not having children was positively correlated with lack of counseling delivered by health care professionals (coefficient 1.147).

37.8% were uncertain about whether mode of delivery could be influenced by underlying IBD. Most of the patients who experienced uncertainty had been to high school or had had a better level of education.

26.6% were uncertain if patients with IBD could breastfeed their babies. They all had gone to college or had had a better level of education.

Only 15.9% were counseled by health care professionals to undergo regular pap smears. This was done by a gastroenterologist (6.87%) and by a gynaecologist (9.44%). 61.8% received information about the HPV vaccine. Most information was given by a gastroenterologist (38.2%) and by a gynaecologist (15.5%). 1.72% had received information from both. 24.9% were using contraception. There was a statistical correlation with a higher level of education (p<0.003).

1.7% of patients stopped medications on their own accord during pregnancy. They all had finished secondary school or had a higher level of education. Reasons given included fear of harm to the baby and being in remission.


A higher level of education can influence decisions such as planning a pregnancy and number of pregnancies. However, this data demonstrates the need for a lot more of appropriate counseling of female IBD patients with regards to pregnancy, breast feeding, cervical smear testing and IBD drugs during pregnancy.