Perceptions of reproductive risk among women with epilepsy of childbearing age.

Autor: Hill CE; Department of Neurology, University of Michigan, Ann Arbor, MI, USA. Electronic address: chloehi@med.umich.edu., Lin CC; Department of Neurology, University of Michigan, Ann Arbor, MI, USA; Department of Neurology, The Ohio State University, Columbus, OH, USA., Suresh S; Department of Neurology, University of Michigan, Ann Arbor, MI, USA; Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA., Shatzman S; Department of Neurology, University of Michigan, Ann Arbor, MI, USA., Shaheid N; Department of Neurology, University of Michigan, Ann Arbor, MI, USA; OhioHealth Physician Group, Mansfield, OH, USA., Seo SH; Department of Neurology, University of Michigan, Ann Arbor, MI, USA., Selwa LM; Department of Neurology, University of Michigan, Ann Arbor, MI, USA., Mihaylova T; Department of Neurology, University of Michigan, Ann Arbor, MI, USA.
Jazyk: angličtina
Zdroj: Epilepsy & behavior : E&B [Epilepsy Behav] 2024 Dec; Vol. 161, pp. 110107. Date of Electronic Publication: 2024 Oct 30.
DOI: 10.1016/j.yebeh.2024.110107
Abstrakt: Background: Having children or planning to have children may raise many questions for women with epilepsy. Seizures and antiseizure medications (ASMs) impact contraception, fetal/early childhood development, and maternal health. Little is known regarding patients' perspectives about reproductive risk and how those perspectives influence reproductive decision-making.
Methods: As a quality improvement initiative, we distributed an electronic survey within our health system to women ages 21-45 with a primary diagnosis of epilepsy/seizures. We then performed an exploratory research study to investigate perceptions of risk of epilepsy and ASMs on reproductive health and decision making. Additionally, we looked at clinical characteristics as possible predictors of fear impacting reproductive decisions.
Results: There were 267 responses (32% responder rate); after exclusion criteria, 233 respondents were included in the study. There were mixed responses about how fear of ASM teratogenicity impacted decisions about having children (33% very much, 34% a little, 33% not at all). While 45% responded that fear of having a child with epilepsy/seizures did not at all affect decisions about having children, for 24% this very much affected their decision. In total 42% of respondents reported they had had children. When we evaluated the impact of certain clinical characteristics, we found ASM number and valproic acid use impacted reproductive decision making, while other expected characteristics (e.g., drug-refractoriness and convulsive seizures) did not.
Discussion: We found variation in perceptions of risk. Overall, our data support the very personalized nature of preferences and the need for individualized counseling when guiding patients in reproductive decision making.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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