Background

Inflammatory bowel disease (IBD) is a chronic illness affecting patients in their childbearing years. The physical effects of IBD on fertility and pregnancy in IBD in remission (e.g. disease is well controlled during conception and throughout pregnancy) are similar to the normal population. However, many women with IBD have high pregnancy-related anxieties and are more likely not to have children compared with women without IBD. The reasons cited for not having children include high levels of pregnancy-related anxieties have been insufficiently explored. The study aimed to explore the lived experience of family planning of women with inflammatory bowel disease (IBD) and their partners with or without IBD, during the reproductive stages of pre-conception, pregnancy and the postnatal period.

Methods

Descriptive phenomenology was used to conduct face-to-face in-depth individual interviews. Purposive sampling was used to select participants with a maximum variation of different demographic and clinical factors, e.g. age, sex, UC/CD diagnosis, disease duration, surgery and geographic location. The NVivo 12 software programme was used to manage the data and Colaizzi’s framework was utilised in thematic data analysis.

Results

Twenty-four participants (21 women 11CD/10UC and three partners) were recruited from out-patient clinics (22 participants) or through the Crohn’s and Colitis UK website (two participants). Women, average age 31 years old (range 27–38), were at different family planning stages: pre-conception six women (three actively planning family and three voluntarily childless); pregnant eight women and two partners; and postpartum seven women and one partner. Three women’s partners, age 32–39, were recruited allowing for additional perspective of the experience being captured. In total, 19 h of interviews data were collected. Six themes were identified: (1) being diagnosed and controlling IBD symptoms, (2) relationship and family planning, (3) sources of information, (4) worries and concerns about pregnancy, (5) post pregnancy care and problems and (6) ways of improving care. Women in pre-pregnancy stage and pregnant expressed a need for more information around these themes: (1) their medication and the impact of IBD on the baby, (2) the genetic risk of passing the disease on. While pregnant and during post-partum stage, women identified a greater need for practical advice and support in relation to breastfeeding and looking after the baby.

Conclusion

Information specific to family planning stages need to be provided, to help women and their partners make the informed decision about family planning. Those who decided not to go down the family route also expressed a need for counselling and support.

中文翻译：

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P058在关键的生殖阶段被诊断患有炎症性肠病的女性患者及其伴侣的计划生育生活经验：一项定性研究

背景

炎症性肠病（IBD）是影响患者生育年龄的慢性疾病。IBD缓解IBD对生育和怀孕的物理影响（例如，在怀孕期间和整个怀孕期间疾病得到良好控制）与正常人群相似。但是，与没有IBD的女性相比，许多IBD的女性与妊娠相关的焦虑高，并且更可能没有孩子。对于没有孩子而提到的原因包括与怀孕相关的焦虑情绪高发，目前尚未充分探讨。这项研究旨在探讨在怀孕前，怀孕和产后的生殖阶段，患有炎症性肠病（IBD）的妇女及其伴侣（有或没有IBD）的计划生育生活。

方法

描述性现象学用于进行面对面的深入个人访谈。目的抽样用于选择参与者，这些参与者具有不同的人口统计学和临床​​因素（例如年龄，性别，UC / CD诊断，疾病持续时间，手术和地理位置）的最大差异。NVivo 12软件程序用于管理数据，而Colaizzi的框架用于主题数据分析。

结果

从门诊诊所（22名参与者）或通过英国克罗恩氏和结肠炎网站（两名参与者）招募了24名参与者（21名11CD / 10UC女性和3名伴侣）。妇女，平均年龄31岁（27-38岁），处于不同的计划生育阶段：受孕前有六名妇女（三名积极计划生育，三名自愿无子女）；怀孕的八名妇女和两名伴侣；产后有七名妇女和一位伴侣。招募了三名年龄在32-39岁之间的女性伴侣，以便从其他角度了解所经历的经历。总共收集了19小时的访谈数据。确定了六个主题：（1）被诊断并控制了IBD症状；（2）关系和计划生育；（3）信息来源；（4）对怀孕的担忧和担忧；（5）产后护理和问题，以及（6）改善护理的方法。处于孕前阶段和怀孕阶段的妇女表示需要围绕以下主题提供更多信息：（1）药物治疗和IBD对婴儿的影响；（2）传染疾病的遗传风险。在怀孕期间和产后阶段，妇女发现在母乳喂养和照顾婴儿方面更加需要实用的建议和支持。

结论

需要提供特定于计划生育阶段的信息，以帮助妇女及其伴侣做出有关计划生育的知情决定。那些决定不走家庭路线的人也表示需要咨询和支持。