Department of Gastroenterology, Palo Alto Medical Foundation, Palo Alto, California.
Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University, Redwood City, California.
Am J Perinatol. 2023 Nov;40(15):1651-1658. doi: 10.1055/s-0041-1740193. Epub 2021 Dec 13.
Inflammatory bowel disease (IBD) reproductive health counseling is associated with higher knowledge, lower voluntary childlessness, greater medication adherence during pregnancy, and improved outcomes of pregnancy. Our aims were to assess counseling and knowledge about IBD and reproductive health in a tertiary care IBD patient population.
We anonymously surveyed women and men ages 18 to 45 cared for at the Stanford IBD clinic about reproductive health and administered the CCPKnow questionnaire. STATA was used to summarize descriptive statistics and compare categorical variables using Fisher's exact test.
Of the 100 patients (54% women) who completed the survey, only 33% reported prior reproductive health counseling. Both men and women considered not having a child due to IBD (31% women, 15% men) and most (83%) had no prior counseling. A minority of patients had an adequate (≥8/17) CCPKnow score (45% women, 17% men). The majority of women with prior pregnancy had pre-existing IBD (67%), yet many did not seek gastrointestinal (GI) care (38% preconception, 25% during pregnancy) and 33% stopped/changed medications, with 40% not discussing this with a physician. Prior counseling was significantly associated with education level ( = 0.013), biologic use ( = 0.003), and an adequate CCPKnow score ( = 0.01). Overall, 67% of people wanted more information on IBD and reproductive health.
In an educated tertiary care cohort, the majority of patients had low CCPKnow scores and rates of IBD reproductive health counseling. Many patients with IBD prior to pregnancy reported no GI care preconception or during pregnancy and stopped/changed medications without consulting a physician. There is an urgent need for proactive counseling by gastroenterologists and obstetricians on IBD and reproductive health.
· There is inadequate reproductive health counseling in IBD.. · Many IBD patients do not seek prenatal/perinatal GI care.. · Patients change medications without consultation.. · GIs and OBs should proactively counsel IBD patients..
炎症性肠病（IBD）生殖健康咨询与更高的知识水平、更低的自愿不孕率、妊娠期间更高的药物依从性以及改善妊娠结局相关。我们的目的是评估在斯坦福 IBD 诊所接受治疗的三级护理 IBD 患者人群中关于 IBD 和生殖健康的咨询和知识。
我们匿名调查了年龄在 18 至 45 岁的女性和男性患者，了解他们的生殖健康状况，并进行 CCPKnow 问卷评估。采用 STATA 汇总描述性统计数据，并使用 Fisher 精确检验比较分类变量。
在完成调查的 100 名患者（54%为女性）中，仅有 33%报告接受过生殖健康咨询。男性和女性均因 IBD 而考虑不要孩子（31%的女性，15%的男性），大多数（83%）之前没有接受过咨询。少数患者的 CCPKnow 评分（ = 0.013），生物制剂使用（ = 0.003）和适当的 CCPKnow 评分（ = 0.01）。之前有过妊娠的女性大多数（67%）已经患有 IBD，但许多人在妊娠前（38%）或妊娠期间（25%）未寻求胃肠道（GI）护理，并且 33%停止/改变了药物治疗，其中 40%未与医生讨论过此事。之前接受过咨询与教育水平（ = 0.013）、生物制剂使用（ = 0.003）和适当的 CCPKnow 评分（ = 0.01）显著相关。总的来说，67%的人希望获得更多关于 IBD 和生殖健康的信息。
在一个受过教育的三级护理队列中，大多数患者的 CCPKnow 评分较低，接受 IBD 生殖健康咨询的比例较低。许多在妊娠前患有 IBD 的患者在妊娠前或妊娠期间未接受 GI 护理，并且在未咨询医生的情况下停止/改变了药物治疗。胃肠病学家和妇产科医生迫切需要主动就 IBD 和生殖健康问题提供咨询。
· IBD 患者生殖健康咨询不足。· 许多 IBD 患者在妊娠前或妊娠期间不寻求胃肠道护理。· 患者在未咨询医生的情况下改变药物治疗。· GI 和 OB 应主动为 IBD 患者提供咨询。
