Voluntary childlessness is increased in women with inflammatory bowel disease

2007 ◽  
Vol 13 (5) ◽  
pp. 591-599 ◽  
Author(s):  
Sheetal R. Marri ◽  
Chul Ahn ◽  
Alan L. Buchman
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Voluntary Childlessness ◽  
Inflammatory Bowel

scholarly journals Reproductive Health and Medication Concerns for Patients With Inflammatory Bowel Disease: Thematic and Quantitative Analysis Using Social Listening (Preprint)

2018 ◽  
Author(s):  
Michelle Sophie Keller ◽  
Sasan Mosadeghi ◽  
Erica R Cohen ◽  
James Kwan ◽  
Brennan Mason Ross Spiegel
Keyword(s):  
Inflammatory Bowel Disease ◽  
Social Media ◽  
Reproductive Health ◽  
Bowel Disease ◽  
Medication Use ◽  
Reproductive Age ◽  
Office Visits ◽  
Voluntary Childlessness ◽  
Qualitative Descriptive ◽  
Inflammatory Bowel

BACKGROUND Inflammatory bowel disease (IBD) affects many individuals of reproductive age. Most IBD medications are safe to use during pregnancy and breastfeeding; however, observational studies find that women with IBD have higher rates of voluntary childlessness due to fears about medication use during pregnancy. Understanding why and how individuals with IBD make decisions about medication adherence during important reproductive periods can help clinicians address patient fears about medication use. OBJECTIVE The objective of this study was to gain a more thorough understanding of how individuals taking IBD medications during key reproductive periods make decisions about their medication use. METHODS We collected posts from 3000 social media sites posted over a 3-year period and analyzed the posts using qualitative descriptive content analysis. The first level of analysis, open coding, identified individual concepts present in the social media posts. We subsequently created a codebook from significant or frequently occurring codes in the data. After creating the codebook, we reviewed the data and coded using our focused codes. We organized the focused codes into larger thematic categories. RESULTS We identified 7 main themes in 1818 social media posts. Individuals used social media to (1) seek advice about medication use related to reproductive health (13.92%, 252/1818); (2) express beliefs about the safety of IBD therapies (7.43%, 135/1818); (3) discuss personal experiences with medication use (16.72%, 304/1818); (4) articulate fears and anxieties about the safety of IBD therapies (11.55%, 210/1818); (5) discuss physician-patient relationships (3.14%, 57/1818); (6) address concerns around conception, infertility, and IBD medications (17.38%, 316/1818); and (7) talk about IBD symptoms during and after pregnancy and breastfeeding periods (11.33%, 206/1818). CONCLUSIONS Beliefs around medication safety play an important role in whether individuals with IBD decide to take medications during pregnancy and breastfeeding. Having a better understanding about why patients stop or refuse to take certain medications during key reproductive periods may allow clinicians to address specific beliefs and attitudes during office visits.

Data for the decrease of “voluntary childlessness” in inflammatory bowel disease

2012 ◽  
Vol 153 (47) ◽  
pp. 1855-1862
Author(s):  
Krisztina Hagymási ◽  
Pál Miheller ◽  
Zsolt Tulassay
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Treatment Options ◽  
Risks And Benefits ◽  
Voluntary Childlessness ◽  
Chronic Disorder ◽  
Anal Anastomosis ◽  
Improve Compliance ◽  
Inflammatory Bowel ◽  
Male Patients

Inflammatory bowel disease is a chronic disorder affecting young adults in their reproductive years, hence its populational consequences are not negligible. While fertility in inflammatory bowel disease is the same with the general population (except for male patients with sulphasalazine treatment and females with ileum-poch anal anastomosis), “voluntary childlessness” is higher, 14–18%. Patients require accurate counseling addressing fertility, pregnancy course and outcome. They need to be informed appropriately about risks and benefits of medications in inflammatory bowel disease in order to assist their decision making, decrease “voluntary childlessness” and improve compliance. Authors review the issues related to fertility, outcome of pregnancy, medical treatment options before and during pregnancy as well as during breastfeeding in inflammatory bowel disease. Orv. Hetil., 2012, 153, 1855–1862.

Patients Report Infrequent Counseling by Physicians and Inadequate Knowledge about Inflammatory Bowel Disease and Reproductive Health Issues

2021 ◽  
Author(s):  
Aarti K. Rao ◽  
Thomas A. Zikos ◽  
Gotzone Garay ◽  
Ko-Eun Lee ◽  
Sarah E. Streett
Keyword(s):  
Inflammatory Bowel Disease ◽  
Reproductive Health ◽  
Bowel Disease ◽  
Tertiary Care ◽  
Categorical Variables ◽  
Exact Test ◽  
Health Counseling ◽  
Voluntary Childlessness ◽  
Inadequate Knowledge ◽  
Inflammatory Bowel

Objective 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. Study Design 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. Results 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 (p = 0.013), biologic use (p = 0.003), and an adequate CCPKnow score (p = 0.01). Overall, 67% of people wanted more information on IBD and reproductive health. Conclusion 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. Key Points

Knowledge and Attitudes Towards Pregnancy in Females with Inflammatory Bowel Disease: An International, Multi-centre Study

2020 ◽  
Vol 14 (9) ◽  
pp. 1248-1255 ◽  
Author(s):  
Robyn Laube ◽  
Yunki Yau ◽  
Christian P Selinger ◽  
Cynthia H Seow ◽  
Amanda Thomas ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Middle Eastern ◽  
International Study ◽  
Models Of Care ◽  
Obstetric Outcomes ◽  
Multi Centre Study ◽  
Voluntary Childlessness ◽  
Support Organization ◽  
Inflammatory Bowel

Abstract Background and Aims Poor knowledge of inflammatory bowel disease [IBD] in pregnancy underlies unwarranted voluntary childlessness [VC], and risks poorer obstetric outcomes and adverse fetal outcomes. IBD is increasing worldwide but education on IBD issues might be heterogeneous based on cultural differences and variations in models of care. Methods Consecutive female IBD subjects aged 18–45 years were prospectively recruited from two dedicated IBD-pregnancy clinics, two multidisciplinary IBD clinics and nine general gastroenterology clinics. Subjects completed the validated CCPKnow [score 0–17] with questions on demographics, medical history and pregnancy knowledge. The primary outcome was knowledge per clinic-type and per geographical region. Results Surveys were completed by 717 subjects from 13 hospitals across ten countries. Dedicated IBD-pregnancy clinics had the highest knowledge, followed by multidisciplinary IBD clinics then general IBD clinics (median CCPKnow 10.0 [IQR: 8.0–11.0], 8.0 [IQR: 5.0–10.5] and 4.0 [IQR:2.0–6.0]; p < 0.001). Median CCPKnow scores in Western, Asian and Middle Eastern clinics were 9.0, 5.0 and 3.0 respectively [p < 0.001]. Dedicated IBD-pregnancy clinics, IBD support organization membership, childbearing after IBD diagnosis and employment independently predicted greater knowledge. Patient perception of disease severity [r = −0.18, p < 0.01] and consideration of VC [r = −0.89, p = 0.031] negatively correlated with CCPKnow score. The overall VC rate was 15.0% [95% CI: 12.2–18.2]. VC subjects had significantly lower pregnancy-specific IBD knowledge than non-VC subjects (median CCPKnow 4.0 [IQR: 2.0–6.0] and 6.0 [IQR: 3.0–9.0] respectively; p < 0.001). Pregnancy-specific IBD knowledge and dedicated IBD-pregnancy clinic attendance were significant negative predictors of VC. Conclusions In this large international study we identified predictors of pregnancy-specific IBD knowledge. Dedicated IBD-pregnancy clinics had the greatest IBD-related pregnancy knowledge and lowest VC rates, reflecting the benefits of pre-conception counselling.

scholarly journals Does the Level of Reproductive Knowledge Specific to Inflammatory Bowel Disease Predict Childlessness among Women with Inflammatory Bowel Disease?

2015 ◽  
Vol 29 (2) ◽  
pp. 95-103 ◽  
Author(s):  
Vivian W Huang ◽  
Hsiu-Ju Chang ◽  
Karen I Kroeker ◽  
Karen J Goodman ◽  
Kathleen M Hegadoren ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Family Planning ◽  
Bowel Disease ◽  
Lower Odds ◽  
Voluntarily Childless ◽  
Voluntary Childlessness ◽  
Childless Women ◽  
Knowledge Questionnaire ◽  
Point Increase ◽  
Inflammatory Bowel

BACKGROUND: Women with inflammatory bowel disease (IBD) may choose to remain childless due to a lack of IBD-specific reproductive knowledge.OBJECTIVES: To examine the effects of IBD-specific reproductive knowledge and discussion of family planning with a physician on childlessness among women with IBD.METHODS: Female IBD patients 18 to 45 years of age completed the Crohn’s and Colitis Pregnancy Knowledge questionnaire (CCPKnow), and answered questions regarding reproductive history, plans to have children and discussion of family planning with a physician. CCPKnow scores were grouped according to poor (0 to 7), adequate (8 to 10), good (11 to 13) and very good (14 to 17).RESULTS: Of 434 eligible women, 248 (57.1%) completed the questionnaires. Of these 248 women, 51.6% were childless and, among these, 12.9% were voluntarily childless and 12.1% were trying to become pregnant. Childless women had a lower median CCPKnow score than women with children (6.0 versus 8.0; P=0.001). After adjusting for current age and marital status, each one point increase in the CCPKnow score corresponded to 8% lower odds of childlessness (OR 0.92 [95% CI 0.86 to 0.99]), 9% lower odds of voluntary child-lessness (OR 0.91 [95% CI 0.79 to 1.0]) and 20% higher odds of trying to become pregnant (OR 1.2 [95% CI 1.0 to 1.4]). Discussion of family planning with a gastroenterologist corresponded to 72% lower odds of a poor CCPKnow score (OR 0.28 [95% CI 0.15 to 0.53]) and of voluntary childlessness (OR 0.28 [95% CI 0.057 to 1.3]).CONCLUSION: In the present study, higher IBD-specific reproductive knowledge lowered the odds of childlessness among women with IBD. Discussion of family planning with a physician was associated with higher CCPKnow scores and lower odds of voluntary childlessness.

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