Gawron Lori M, Goldberger Adina R, Gawron Andrew J, Hammond Cassing, Keefer Laurie
Assistant Professor, Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, UT, USA.
Medical Student, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
J Fam Plann Reprod Health Care. 2015 Oct;41(4):272-7. doi: 10.1136/jfprhc-2014-101000. Epub 2015 Apr 22.
Women with inflammatory bowel diseases (IBD) endorse disease-related pregnancy concerns that influence parity. Improvements in IBD management have potentially altered reproductive planning. Additionally, the proportion of American women who choose not to have children is increasing.
To explore the effect of disease-related pregnancy concerns on parity and reproductive planning in a subset of women with IBD.
Cross-sectional qualitative phone survey in an academic gastroenterology practice.
Questions included demographics, medical and reproductive history, future pregnancy plans, and if IBD affected pregnancy decision-making. Qualitative data were coded and frequencies and proportions calculated.
The 129 female participants (31% response rate) were predominately white (85%), had at least some college education (97%) and a mean age of 34.3 years [standard deviation 6.2]. Some 60% had Crohn's disease and 30% had undergone IBD-related surgery. Half were nulliparae, 53% reported IBD-related pregnancy concerns and 57% desired future pregnancy. Women who desired a future pregnancy and had IBD-related concerns had higher parity than those without concerns (p=0.02). Women desiring a future pregnancy and those with Crohn's disease had increased IBD-related concerns. Only four (3.1%) women identified IBD-related concerns that led to a smaller family size than desired.
IBD-related concerns appear to be less likely to affect a woman's planned family size than previously reported. Concern about adverse pregnancy outcomes is more common in women with Crohn's disease and those desiring future pregnancy, suggesting a need for targeted counselling to moderate risk perception.
患有炎症性肠病（IBD）的女性表达了与疾病相关的妊娠担忧，这些担忧会影响生育情况。IBD管理的改善可能改变了生育计划。此外，选择不生育的美国女性比例正在增加。
探讨疾病相关的妊娠担忧对一部分IBD女性生育情况和生育计划的影响。
在一家学术性胃肠病科诊所进行的横断面定性电话调查。
问题包括人口统计学、医疗和生育史、未来妊娠计划，以及IBD是否影响妊娠决策。对定性数据进行编码，并计算频率和比例。
129名女性参与者（回复率31%）主要为白人（85%），至少接受过一些大学教育（97%），平均年龄34.3岁[标准差6.2]。约60%患有克罗恩病，30%接受过与IBD相关的手术。一半为未生育女性，53%报告有与IBD相关的妊娠担忧，57%希望未来怀孕。希望未来怀孕且有IBD相关担忧的女性比没有担忧的女性生育次数更多（p=0.02）。希望未来怀孕的女性和患有克罗恩病的女性有更多与IBD相关的担忧。只有四名（3.1%）女性认为与IBD相关的担忧导致家庭规模小于预期。
与IBD相关的担忧似乎比之前报道的更不太可能影响女性计划的家庭规模。对不良妊娠结局的担忧在患有克罗恩病的女性和希望未来怀孕的女性中更为常见，这表明需要进行有针对性的咨询以减轻风险认知。
