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P126 Low reproductive knowledge and fertility in patients with inflammatory bowel disease in Serbia—results of pilot study

T. Glisic*1, A. Sokic-Milutinovic1, S. Zgradic1, I. Jovicic1

1Clinic for Gastroenterology and Hepatology, Belgrade, Serbia

Background

Inflammatory bowel diseases (IBD) are predominantly diagnosed in young patients who are in the reproductive period. Misconceptions associated with the lack of adequate information can force patients to ignore available medical evidence of pregnancy safety leading to voluntary childlessness.

Methods

In this pilot study, 80 female IBD patients (aged 18–67) treated in the Clinic for Gastroenterology and Hepatology Clinical Center of Serbia, completed standardised questionnaire consisting of demographic characteristics, pregnancy and abortion data, IBD phenotype and therapy. Disease related pregnancy knowledge was assessed using previously described Crohn’s and colitis pregnancy knowledge score (CCPKnow). CCPKnow consists of 18 questions and scores lower than 7 are considered poor. Patients were divided according to the diagnosis into the group with ulcerative colitis (UC) and Crohn's disease (CD). These two groups were further stratified according to the presence of pregnancy after IBD diagnosis.

Results

We analysed data from 80 IBD patients (42 UC, 38 CD). In UC group 8 (19%) and in CD group 8(21%) were childless. After IBD was diagnosed 33 (78.6%) UC and 32 (84.6%) CD patients were not pregnant. Six patients (3 UC, 3 CD) stated that IBD diagnosis was the sole reason for voluntary childlessness. Total of 14 pregnancies was found in 9 UC patients while in CD patients total of 6 women had 10 pregnancies after IBD diagnosis. Statistically significant difference was shown only in UC patients when average number of children was compared between groups with and without pregnancy after IBD diagnosis (2.00 vs. 1.03, p < 0.05).In CD there was the same trend but significant difference was not observed. Average CCPKnow scores were poor in both groups (5.44 in UC vs. 4.38 in CD). CCPKnow scores showed better knowledge, both in UC and CD patients, among women who gave birth after IBD diagnosis compared with those who did not (UC: 6.44 vs. 5.16; CD: 5.83 vs. 4.11, respectively). Better knowledge in UC than in CD patients about the chances of pregnancy during IBD (p < 0.001) and regarding mesalazine safety in pregnancy was demonstrated (p < 0.013).

Conclusion

Our study confirmed that voluntary childlessness is a common occurrence in female patients with IBD. The CCPKnow score is extremely low in the examined population and specific reproductive knowledge in IBD is lower in CD patients, which points to the great need for fertility related education of IBD patients in our country.