Self-reported Antenatal Adherence to Medical Treatment Among Pregnant Women with Crohn's Disease

Background: Adherence to medical treatment among women with Crohn's disease (CD) prior to and during pregnancy has never been reported.

Aim: To examine both the predictors and prevalence rates of non-adherence to maintenance medical treatment among women with CD prior to and during pregnancy.

Methods: Among a population of 1.6 million inhabitants, we identified a total of 132 women with CD who had given birth during 2000-2005. Questionnaires were used to investigate predictors and extent of adherence. The validity of self-reported use of medication was assessed using data from the Danish Prescription Database. We used logistic regression to estimate prevalence odds ratios for non-adherence according to smoking status and other predictors.

Results: Eighty percent of the patients returned the questionnaire. A total of 58 (54%) women reported to have been on medical treatment, 50 of whom had fulfilled a prescription on relevant medication. Adherence to medical treatment was 72%. Fear of a negative effect on fertility/foetus was a reason for non-adherence by 18.8% prior to, and by 45.5% during, pregnancy. Among smokers, 30.8% were non-adherent compared with 11.5% among nonsmokers (prevalence odds ratio 3.41, 95% CI 0.8-14.7).

Conclusions: Despite fear of a negative effect on fertility/foetus, adherence to medical treatment is high in women with CD. There is no substantial variation in adherence prior to and during pregnancy. Smoking prior to pregnancy is a predictor of non-adherence.