PTH-077 Fertility and pregnancy related misconceptions in female patients with inflammatory bowel disease
Bibliographic record
Abstract
Introduction Reproductive issues in patients with inflammatory bowel disease (IBD) have been shown to be inadequately addressed by clinicians. Patients appear to opt for voluntary childlessness due to misconceptions about fertility and pregnancy. Method Female IBD patients were prospectively recruited from 5 different European centres. They were interviewed through the use of a questionnaire. Results 233 patients were recruited (mean age 40; SD±11.9). The mean age at diagnosis was 31.4 years (SD±11.2). 85.5% patients with ulcerative colitis (UC) had a Montreal classification of E2 or E3. Crohn’s disease (CD) patients predominantly (64.7%) had a non-stricturing and non-penetrating phenotype. Only 57.9% of patients were counselled on IBD and fertility (gastroenterologists 46.8%; gynaecologists 7.30%). 27.5% had admitted to considering voluntary childlessness. This correlated with lack of counselling delivered by health care professionals (coefficient 1.147; p < 0.003). Reasons included: (i) fear of harm from the disease to the baby (52.8%); (ii) fear of harm from medications to the baby (61.4%); (iii) fear of passing on IBD to the baby (57.9%); (iv) fear of having a complicated pregnancy (51.5%); (v) being incapable of taking care of their child after birth (8.6%). 19.7% expressed fear of infertility following the diagnosis of IBD. 8.2% were aware that the mode of delivery could be influenced by IBD. 15.5% and 36.5% knew that surgery could influence fertility and mode of delivery respectively. Regarding IBD medications during pregnancy: (i) 15.0% thought that all medications should be stopped; (ii) 12.0% believed that some medications should be stopped; (iii) 63.1% were unsure about what to do with medications. 1.7% of patients stopped medications without consultation with clinical teams. 26.6% of patients were uncertain if patients with IBD could breast feed. 37.0% said that they could not. 47.0% thought that females with IBD could not breastfeed due to medications crossing into the breast milk. 15.9% were counselled to undergo regular pap smears. 61.8% received information about the HPV vaccine. Conclusion The effects of inadequate fertility counselling in patients with IBD in Europe might contribute to the high levels of voluntary childlessness. A number of misconceptions about pregnancy and delivery exist. This study highlights the need to improve care for this cohort of patients through the development of a multidisciplinary team management. Further studies might allow us to evaluate the most effective way of delivering improved support for these patients. Disclosure of interest None Declared.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".