title: Inflammatory bowel disease and pregnancy: lack of knowledge is associated with negative views.
abstract: BACKGROUND
  Enabling women with inflammatory bowel diseases (IBD) to have successful pregnancies requires complex decisions. The study aimed to assess patients' views on IBD and pregnancy and to evaluate any association with subject knowledge.
  
  
  METHODS
  General attitudes of females with IBD were assessed on fertility, medication use, delivery mode and pregnancy outcomes. Attitudes regarding personal situation were assessed in participants nulliparous since IBD diagnosis. Knowledge of pregnancy-related issues in IBD was assessed by the Crohn's and Colitis Pregnancy Knowledge Score 'CCPKnow'.
  
  
  RESULTS
  Of 145 participants 68% of participants agreed with need for medical therapy for flares during pregnancy, but 24% felt it more important to tolerate symptoms. 36% believed that all IBD medication is harmful to unborn children. Of 96 women nulliparous after IBD diagnosis, 46% were worried about infertility, 75% expressed concern about passing IBD to offspring and 30% considered not having children. Nearly all participants worried about the effects of IBD on pregnancy and the effects of pregnancy on IBD. General attitudes that 'medication should be stopped prior to conception' (P<0.001), 'pregnant women should avoid all IBD drugs' (P<0.001), and 'put up with symptoms' (P<0.001) were associated with significantly lower CCPKnow scores.
  
  
  CONCLUSIONS
  Over a third of patients considered IBD medication harmful to unborn children. Fear of infertility and concerns about inheritance may explain high rates of voluntary childlessness. Attitudes contrary to medical evidence were associated with significantly lower knowledge. Young women with IBD, particularly those with poor knowledge, should be offered education and counselling about pregnancy-related issues.
authors.affiliation: Gastroenterology and Liver Services, Concord Hospital and Bankstown Hospital, Sydney, Australia. Christian.selinger@web.de
authors.forename: Christian P
authors.initials: CP
authors.lastname: Selinger
authors.forename: Jayne
authors.initials: J
authors.lastname: Eaden
authors.forename: Warwick
authors.initials: W
authors.lastname: Selby
authors.forename: D Brian
authors.initials: DB
authors.lastname: Jones
authors.forename: Peter
authors.initials: P
authors.lastname: Katelaris
authors.forename: Grace
authors.initials: G
authors.lastname: Chapman
authors.forename: Charles
authors.initials: C
authors.lastname: McDondald
authors.forename: John
authors.initials: J
authors.lastname: McLaughlin
authors.forename: Rupert W L
authors.initials: RW
authors.lastname: Leong
authors.forename: Simon
authors.initials: S
authors.lastname: Lal
mesh_terms: D000328:Adult; D001294:Attitude to Health; D001942:Breast Feeding; D003657:Decision Making; D005260:Female; D005298:Fertility; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000523:psychology*; D010298:Parity; D011247:Pregnancy; D011248:Pregnancy Complications / Q000523:psychology*; D011795:Surveys and Questionnaires