Breastfeeding Counseling in Women with Epilepsy: Neurologists and Obstetricians Experiences
Abstract number :
2.166
Submission category :
4. Clinical Epilepsy / 4E. Women's Issues
Year :
2022
Submission ID :
2204206
Source :
www.aesnet.org
Presentation date :
12/4/2022 12:00:00 PM
Published date :
Nov 22, 2022, 05:23 AM
Authors :
Abrar Al-Faraj, MD – Boston University; isabelle Messina, Bachelor – Boston University; Deeya Modhwadiya, Bachelor – Boston University; Jessica LeClair, PhD – Boston University; rebecca Summit, Bachelor – Brigham and Women's Hospital; Trudy Pang, MD – Beth Israel Deaconess Medical Center/Harvard Medical School
Rationale: Characterize neurologists' and obstetricians' practice patterns in breastfeeding (BF) counseling for women with epilepsy (WWE) and to explore barriers to BF counseling in WWE.
Methods: We conducted a cross-sectional cohort study via an anonymous unvalidated survey from September 2021 until November 2021. A 21-question unvalidated survey was developed to examine the following domains: (1) BF counseling behavior including the level of comfort in providing BF counseling for WWE, (2) responsibility of BF counseling for WWE, (3) influence of evidence-based research and clinical guidelines on BF counseling, and (4) adequacy of the current research about ASM and breastfeeding in WWE, (5) Barriers that may influence BF counseling in WWE.
Subjects: Neurologists were recruited from the American Epilepsy Society and the American Academy of Neurology. Obstetricians were recruited via direct outreach in academic institutions in the United States and via the American College of Obstetricians and Gynecologists.
Statistical Methods: Descriptive statistics were generated for each survey question. We classified specialists as two distinct groups: neurologists and obstetricians. A two-sided significance level of 5% was used to determine statistical significance in all analyses. SAS 9.4 was used to perform all statistical analyses. Adjusted odds ratios (for years of experience and fellowship training) were calculated to assess the association between external barriers and Counseling.
Results: A total of 182 participants completed the survey: Neurologists (53.85%), and Obstetricians (46.15%).
- Among neurologists, and obstetricians, 60% of providers conceptually believe that BF counseling is important for WWE in reproductive age. And Both neurologists (87.57%) and obstetricians (85.41%) believe that BF counseling for WWE is a shared responsibility.
- Nearly one-third (36.94%) feel somewhat comfortable/uncomfortable in providing BF counseling for WWE.
- Most providers stated that their BF counseling is largely influenced by evidence-based research (84.86%). However, only (16.76%) thought that the current research about BF in WWE is sufficient, and 30.81% thought it was inadequate.
- Compared to neurologists, more obstetricians (odds ratio 2.78, p= 0.0084) identify conflicting perspectives about BF may represent a barrier to effective BF counseling in WWE._x000D_
Conclusions:
- BF counseling in WWE is an important consideration and is a shared responsibility by both Neurologists and Obstetricians. _x000D_
- Obstetricians believe that conflicting perspectives about BF safety provided from different sub-specialties is a potential barrier to effective BF counseling. _x000D_
- Comfort levels in BF counseling in WWE vary among specialists; one-third of participants feel they are uncomfortable in providing BF counseling. Training and education about BF counseling may be needed to improve the comfort level and effectiveness of BF counseling. _x000D_
- Only a small percentage of neurologists and obstetricians feel current sources are sufficient to guide breastfeeding recommendations. This underscores the need for additional research about the safety of ASM with BF in WWE and updated practice clinical guidelines for the management of WWE.
Funding: None
Clinical Epilepsy