P343 Misconceptions about reproductive issues in female 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
The quality of life of female patients with inflammatory bowel disease (IBD) has improved such that they are very often considering pregnancy. However, there are still a lot of reproductive issues that are not being addressed. Women with IBD may opt for voluntary childlessness due to certain misconceptions. The aim of this study was to determine the prevalence and type of misconceptions among female IBD patients.
This was a retrospective study were patients were recruited from 5 different 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 was 31.4 years (SD±11.2). 85.5% of patients with ulcerative colitis (UC) had a Montreal classification of E2 or E3. Most Crohn's disease (CD) patients (64.7%) had non-stricturing and non-penetrating disease.
27.5% considered voluntary childlessness. 52.8% were afraid of harm of IBD to the baby. 61.4% reported fear of IBD medications to the baby. 57.9% were scared of passing on IBD to the baby. 51.5% feared having a complicated pregnancy due to IBD. Only 8.6% were afraid of being incapable of taking care of their child after birth because of IBD. However, another 9% gave other reasons.
19.7% experienced fear of not becoming pregnant at some point in their lives following the diagnosis of IBD. 8.2% were aware that mode of delivery could be influenced by IBD.
15.5% were aware that surgery could influence fertility. Only 36.5% of patients were aware that surgery could influence mode of delivery.
26.6% of patients were uncertain if patients with IBD could breast feed. 36.4% thought that females with IBD could breast feed and the rest (37%) said that they could not. 40.7% thought that females with IBD could not breast feed due to medications crossing into the breast milk and causing harm to the baby.
15.0% thought that all medications should be stopped during pregnancy due to safety to the fetus. 63.1% of patients were unsure. 12.0% claimed that only some medications should be stopped during pregnancy. 5-ASA was considered as a very safe medication by practically all patients.
A significant proportion of patients considered voluntary childlessness or feared infertility. An alarmingly high percentage of patients were not aware that mode of delivery is influenced by past surgery and IBD and that surgery could influence fertility. Misconceptions about breast feeding and medications during pregnancy were evident. This highlights the importance of more patient support groups, leaflets and the need for health care professionals to deliver appropriate information.