Inflamm Bowel Dis. 2021 Mar 11;izab021.doi: 10.1093/ibd/izab021. Online ahead of print.

Emma Flanagan ^1 2, Emily K Wright ^1 2, Miles P Sparrow ^3 4, Gregory T Moore ^4 5, William R Connell ¹, Peter De Cruz ^2 6, Britt Christensen ⁷, Edward Shelton ⁵, Michael A Kamm ^1 2, Mark G Ward ^3 4, Damian Dowling ⁸, Steven Brown ¹, Soleiman Kashkooli ⁹, Alexander J Thompson ^1 2, Alyson L Ross ¹, Katerina V Kiburg ^1 2, Sally J Bell ^1 5

Author information

• ¹Department of Gastroenterology, St. Vincent's Hospital, Melbourne, Australia.
• ²Department of Medicine, University of Melbourne, Melbourne, Australia.
• ³Department of Gastroenterology, The Alfred Hospital, Melbourne, Australia.
• ⁴Department of Gastroenterology, Monash University, Melbourne, Australia.
• ⁵Department of Gastroenterology, Monash Health, Melbourne, Australia.
• ⁶Department of Gastroenterology, Austin Health, Melbourne, Australia.
• ⁷Department of Gastroenterology, The Royal Melbourne Hospital, Melbourne, Australia.
• ⁸Department of Gastroenterology, Barwon Health, Geelong, Australia.
• ⁹Department of Gastroenterology, Northern Health, Melbourne, Australia.

Abstract

Background: There is considerable interest in improving the education and care of women with inflammatory bowel disease (IBD) to improve pregnancy outcomes. Despite increased awareness, not all women with IBD have access to pregnancy-related education and the quality of counseling is variable. We aimed to assess the effectiveness of a simple educational intervention for improving pregnancy-related knowledge and to evaluate the effect of education on patient outcomes including anxiety, depression, and quality of life in women with IBD.

Methods: This prospective study of women with IBD who were pregnant or planning a pregnancy evaluated the effectiveness of a single gastroenterologist-led educational intervention in improving pregnancy-related knowledge, measured using the Crohn's and Colitis Pregnancy Knowledge score 1 month postintervention. Secondary outcomes included the effect on anxiety and depression, quality of life, medication adherence, and patient satisfaction.

Results: One hundred women with IBD were recruited. Fifty percent were pregnant at the time of the intervention. Baseline knowledge scores were similar independent of the patients' pregnancy status or whether they had previously received counseling from their gastroenterologist. Median Crohn's and Colitis Pregnancy Knowledge scores postintervention (n = 82) were higher than preintervention scores (14/17 vs 10/17; P < 0.001). In addition, 32% of patients had poor knowledge at baseline (score ≤7/17), compared to only 5% after the intervention (P < 0.001). There was a significant improvement in total anxiety and depression and quality of life scores postintervention. Medication adherence and patient satisfaction were excellent.

Conclusions: Uptake of this gastroenterologist-led educational intervention has the potential to improve pregnancy knowledge, promote medication adherence, and enhance quality of life for women with IBD globally.