Department of Internal Medicine I, Martin Luther University of Halle-Wittenberg, Halle, Germany.
Z Gastroenterol. 2021 Aug;59(8):841-850. doi: 10.1055/a-1404-3610. Epub 2021 Mar 18.
In patients with inflammatory bowel disease (IBD), diagnosis is often established at the beginning of childbearing age. Accordingly, concerns about family planning and pregnancy (FPP) are common. Poor knowledge regarding FPP might contribute to increased childlessness in patients with IBD.
The Crohn's and Colitis Pregnancy Knowledge Score (CCPKnow, 17 multiple-choice questions) was translated into German and then used for a web-based survey. Childlessness was analyzed with respect to socio-demographic and disease-related information, and the knowledge (CCPKnow) and concerns of IBD patients with children were compared to those of voluntarily childless (VC) and non-voluntarily childless (NVC) IBD patients.
Childlessness was observed in 57.4 % of the 533 participants (90.6 % women, 63.0 % Crohn's disease, 31.5 % ulcerative colitis, mean age 33.2 ± 8.6 years), voluntary childlessness in 9 %. The mean overall CCPKnow was adequate (9.38 ± 3.96). Poor knowledge was not associated with increased childlessness (CCPKnow of < 8 was found in 29.8 % of patients with children and 28.9 % of childless patients, p > 0.5). Instead, the patients' education, medical advice, FPP-related concerns, impaired body image, and sexual dysfunction had a significant impact on childlessness. Frequent concerns included adverse effects of the patient's medication on their child (36 % of the respondents), malformation (33 %), miscarriage (34.5 %), and the inheritability of IBD (57 %).
Factual knowledge does not reduce disease-related concerns or childlessness. Correct but possibly bothersome information on FPP might contribute to childlessness in patients with IBD. Our findings underline the need for qualified counseling of IBD patients regarding FPP by an experienced IBD physician.
在炎症性肠病（IBD）患者中，诊断通常在生育年龄开始时确立。因此，对计划生育和妊娠（FPP）的担忧很常见。对 FPP 的了解不足可能导致 IBD 患者的生育率下降。
克罗恩病和结肠炎妊娠知识评分（CCPKnow，17 个多项选择题）被翻译成德语，然后用于在线调查。根据社会人口统计学和疾病相关信息分析了不育情况，并比较了有子女的 IBD 患者与自愿不育（VC）和非自愿不育（NVC）IBD 患者的知识（CCPKnow）和担忧。
533 名参与者中有 57.4%（90.6%为女性，63.0%为克罗恩病，31.5%为溃疡性结肠炎，平均年龄 33.2±8.6 岁）有不育情况，自愿不育为 9%。总体 CCPKnow 平均水平适中（9.38±3.96）。知识不足与不育率增加无关（有子女患者中 CCPKnow<8 的比例为 29.8%，无子女患者为 28.9%，p>0.5）。相反，患者的教育程度、医疗建议、FPP 相关问题、身体形象受损和性功能障碍对不育有显著影响。患者经常关注的问题包括患者药物对其子女的不良影响（36%的受访者）、畸形（33%）、流产（34.5%）和 IBD 的遗传性（57%）。
事实知识并不能减轻与疾病相关的担忧或不育。关于 FPP 的正确但可能令人烦恼的信息可能会导致 IBD 患者不育。我们的研究结果强调了需要由有经验的 IBD 医生为 IBD 患者提供有关 FPP 的合格咨询。
