title: Self-reported antenatal adherence to medical treatment among pregnant women with Crohn's disease.
abstract: BACKGROUND
  Adherence to medical treatment among women with Crohn's disease (CD) prior to and during pregnancy has never been reported.
  
  
  OBJECTIVE
  To examine both the predictors and prevalence rates of non-adherence to maintenance medical treatment among women with CD prior to and during pregnancy.
  
  
  METHODS
  Among a population of 1.6 million inhabitants, we identified a total of 132 women with CD who had given birth during 2000-2005. Questionnaires were used to investigate predictors and extent of adherence. The validity of self-reported use of medication was assessed using data from the Danish Prescription Database. We used logistic regression to estimate prevalence odds ratios for non-adherence according to smoking status and other predictors.
  
  
  RESULTS
  Eighty percent of the patients returned the questionnaire. A total of 58 (54%) women reported to have been on medical treatment, 50 of whom had fulfilled a prescription on relevant medication. Adherence to medical treatment was 72%. Fear of a negative effect on fertility/foetus was a reason for non-adherence by 18.8% prior to, and by 45.5% during, pregnancy. Among smokers, 30.8% were non-adherent compared with 11.5% among nonsmokers (prevalence odds ratio 3.41, 95% CI 0.8-14.7).
  
  
  CONCLUSIONS
  Despite fear of a negative effect on fertility/foetus, adherence to medical treatment is high in women with CD. There is no substantial variation in adherence prior to and during pregnancy. Smoking prior to pregnancy is a predictor of non-adherence.
authors.affiliation: Department of Medicine V, Aarhus University Hospital, Denmark. mjn@ki.au.dk <mjn@ki.au.dk>
authors.forename: M J
authors.initials: MJ
authors.lastname: Nielsen
authors.forename: M
authors.initials: M
authors.lastname: Nørgaard
authors.forename: P
authors.initials: P
authors.lastname: Holland-Fisher
authors.forename: L A
authors.initials: LA
authors.lastname: Christensen
mesh_terms: D000328:Adult; D003424:Crohn Disease / Q000188:drug therapy* / Q000453:epidemiology; D003718:Denmark / Q000453:epidemiology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D010349:Patient Compliance / Q000706:statistics & numerical data*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011295:Prenatal Care / Q000523:psychology*; D015995:Prevalence; D012044:Regression Analysis; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D011795:Surveys and Questionnaires; D055815:Young Adult