Poor inflammatory bowel disease (IBD) pregnancy knowledge underlies unwarranted voluntary childlessness (VC), risks poorer obstetric outcomes and adverse foetal outcomes. IBD is increasing worldwide but education on IBD issues might be heterogeneous based on cultural differences and variations in models of care.
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.
Surveys were completed by 717 subjects from thirteen 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], 4.0 [IQR:2.0-6.0]; P<0.001). The median CCPKnow in Western, Asian and Middle Eastern clinics were 9.0, 5.0, 3.0 respectively (P<0.001). Dedicated IBD-pregnancy clinics, IBD support organisation 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.
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.

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