Knowledge, Values and Preferences regarding Contraceptive Choices among Women living with Inflammatory Bowel Disease

Jimmy K Limdi; Sarah Rhodes; Eleanor Liu; Anish J Kuriakose Kuzhiyanjal; Matthew Brookes; Jennifer Farraye; Rachel Cannon; Elisabeth Woodhams; Francis A Farraye

doi:10.1093/ecco-jcc/jjae181

Knowledge, Values and Preferences regarding Contraceptive Choices among Women living with Inflammatory Bowel Disease

J Crohns Colitis. 2024 Nov 27:jjae181. doi: 10.1093/ecco-jcc/jjae181. Online ahead of print.

Authors

Jimmy K Limdi^{1

2}, Sarah Rhodes³, Eleanor Liu¹, Anish J Kuriakose Kuzhiyanjal¹, Matthew Brookes⁴, Jennifer Farraye⁵, Rachel Cannon⁵, Elisabeth Woodhams⁵, Francis A Farraye⁶

Affiliations

¹ Northern Care Alliance NHS Foundation Trust, Division of Gastroenterology-Section of IBD, Manchester, United Kingdom.
² Manchester Academic Health Sciences, University of Manchester, UK.
³ Centre for Biostatistics, Division of Population Health, Health Services Research and Primary Care, University of Manchester.
⁴ Royal Wolverhampton Hospital NHS Foundation Trust, Wolverhampton, UK.
⁵ Department of Obstetrics and Gynecology, Boston Medical Center, Boston, MA.
⁶ Professor of Medicine- The Mayo Clinic, Division of Gastroenterology and Hepatology, Director- Inflammatory Bowel Disease Center, Jacksonville, Florida, USA.

PMID: 39602552
DOI: 10.1093/ecco-jcc/jjae181

Abstract

Background and aims: Active inflammatory bowel disease at conception is associated with adverse pregnancy outcomes. International guidelines address antenatal care, but contraception counselling and risk assessment are not addressed. Data on healthcare professionals' guidance for women with IBD regarding contraception are scarce. We aimed to describe contraceptive use, preferences, knowledge, and barriers among women with IBD.

Methods: A 34-item questionnaire was administered to female IBD patients aged 18-45. Disease control was measured using PRO2 and IBD Control questionnaire, and contraceptive preferences were assessed by the Contraceptive Features Survey. Logistic regression explored associations between contraceptive use, attitudes, disease remission status, and other factors.

Results: Of 338 women surveyed, 243 (74%) used some form of contraception. Oral birth control pills (28%) and barrier methods (18%) were most used but 20% used long-acting methods. Women with active disease were more likely to use long-acting contraception (23%) compared to those in remission (17%). Contraceptive priorities were effectiveness (78%), ease of use (75%), and minimal side effects (68%). Only 25% women had discussed reproductive issues with their IBD clinician, though 85% were comfortable to do so. Preferred sources for reproductive counselling were IBD nurses (79%), general practitioners (75%), IBD doctors (68%), and gynaecologists (49%).

Conclusion: A quarter of women with IBD were not using any contraception, and long-acting contraceptive use was low. Women prefer effective, easy-to-use contraceptives with minimal side effects but lack knowledge on effective contraception-related issues. Better education and proactive discussions between healthcare providers and patients could improve reproductive health in women with IBD.

Keywords: Contraception; Inflammatory bowel disease; Pregnancy.

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