Brenner Erica J, Grewe Mary E, Berenblum Tobi Catalina, Bryant Amy G, Dubinsky Marla C, Zhang Xian, Long Millie D, Kappelman Michael D, Buchbinder Mara
Division of Pediatric Gastroenterology, Department of Pediatrics, Center for Gastrointestinal Biology and Disease, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
North Carolina Translational and Clinical Sciences Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Crohns Colitis 360. 2024 Dec 20;7(1):otae078. doi: 10.1093/crocol/otae078. eCollection 2025 Jan.
BACKGROUND/AIMS: Active inflammatory bowel disease (IBD) increases the risk of pregnancy complications and contraceptive side effects, and contraceptive use may impact the clinical course of IBD. Although young people are at elevated risk for unintended pregnancy, those with IBD receive minimal disease-specific contraceptive guidance. We characterized perspectives and preferences on contraception and reproductive health counseling from young women with IBD.
We conducted 60-min semi-structured interviews with -women with IBD ages 18-30 (recruited nationwide and from North Carolina IBD clinics; February-June 2023). Interview guides included questions about reproductive health and preferences for receiving reproductive health information. Audio-recordings were professionally transcribed and coded using an inductive, thematic approach and Dedoose software.
Participants included 30 women with IBD (ages 18-30, 77% White, 7% Hispanic, and 55% Crohn's disease). Some participants shared that IBD increased their menstrual symptom burden, prompting contraceptive use to control menses. Participants discussed the impact of IBD on their contraceptive decision-making, including concerns regarding blood clots. For a participant subset, IBD did not impact contraceptive decision-making. Participants discussed how IBD impacted their perspectives on childbearing, including concerns about IBD heritability, infertility, and peripartum IBD flares. Participants wanted their gastroenterology provider to proactively address reproductive health, provide appropriate resources, and coordinate care with reproductive health providers.
Young -women with IBD may have IBD-specific concerns about contraceptives, pregnancy, and menstrual symptoms and desire better IBD-related reproductive health counseling. Inflammatory bowel disease providers can improve reproductive health counseling by proactively addressing IBD-specific reproductive health questions, providing reproductive health resources, and coordinating care.
背景/目的：活动性炎症性肠病（IBD）会增加妊娠并发症和避孕副作用的风险，而使用避孕措施可能会影响IBD的临床病程。尽管年轻人意外怀孕的风险较高，但患有IBD的人很少得到针对该疾病的避孕指导。我们对患有IBD的年轻女性在避孕和生殖健康咨询方面的观点和偏好进行了描述。
我们对年龄在18至30岁之间的患有IBD的女性进行了60分钟的半结构化访谈（在全国范围内以及北卡罗来纳州的IBD诊所招募；2023年2月至6月）。访谈指南包括有关生殖健康以及接受生殖健康信息偏好的问题。音频记录经过专业转录，并使用归纳式主题方法和Dedoose软件进行编码。
参与者包括30名患有IBD的女性（年龄18至30岁，77%为白人，7%为西班牙裔，55%患有克罗恩病）。一些参与者表示，IBD增加了她们的月经症状负担，促使她们使用避孕措施来控制月经。参与者讨论了IBD对她们避孕决策的影响，包括对血栓的担忧。对于一部分参与者来说，IBD并未影响避孕决策。参与者讨论了IBD如何影响她们对生育的看法，包括对IBD遗传、不孕以及围产期IBD发作的担忧。参与者希望她们的胃肠病学医生能够主动关注生殖健康，提供适当的资源，并与生殖健康提供者协调护理。
患有IBD的年轻女性可能对避孕、怀孕和月经症状有与IBD相关的担忧，并希望获得更好的与IBD相关的生殖健康咨询。炎症性肠病提供者可以通过主动解决与IBD相关的生殖健康问题、提供生殖健康资源以及协调护理来改善生殖健康咨询。
