Dataset Information

Rheumatologists' knowledge of contraception, teratogens, and pregnancy risks.

ABSTRACT: Introduction:Rheumatologists are essential partners in planning and managing pregnancies in women with lupus. Whether they know the essentials of contraceptive and medical treatment in pregnancy, however, is unknown. Method:Anonymous in-lecture surveys were completed by 270 rheumatologists to assess knowledge of contraceptive effectiveness, emergency contraception, medication teratogenicity, and lupus pregnancy risk assessment. Results:Rheumatologists knew the high effectiveness of the intrauterine device, but over-estimated the effectiveness of injectable medroxyprogesterone and condoms. Almost all identified methotrexate as a teratogen, but only 69% identified cyclophosphamide and 37% mycophenolate. Most rheumatologists knew that lupus activity in pregnancy is the main predictor of pregnancy outcomes, but underestimated the risks of hypertension and race. Conclusion:To improve lupus pregnancy planning and management, rheumatologists would benefit from improved knowledge about contraceptive effectiveness, teratogens, and the risks from non-lupus factors for pregnancy complications.

SUBMITTER: Clowse ME

PROVIDER: S-EPMC6295764 | biostudies-literature | 2018 Dec

REPOSITORIES: biostudies-literature

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Rheumatologists' knowledge of contraception, teratogens, and pregnancy risks.

Clowse Megan Eb ME Eudy Amanda M AM Revels Jessica J Sanders Gillian D GD Criscione-Schreiber Lisa L

Obstetric medicine 20180504 4

<h4>Introduction</h4>Rheumatologists are essential partners in planning and managing pregnancies in women with lupus. Whether they know the essentials of contraceptive and medical treatment in pregnancy, however, is unknown.<h4>Method</h4>Anonymous in-lecture surveys were completed by 270 rheumatologists to assess knowledge of contraceptive effectiveness, emergency contraception, medication teratogenicity, and lupus pregnancy risk assessment.<h4>Results</h4>Rheumatologists knew the high effectiv ...[more]

PMID: 30574180

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Project description:INTRODUCTION:Reports on the reproductive health of women with epilepsy (WWE) in low- and middle-income countries (LMICs) are limited. Bhutan is a lower income country with a high estimated prevalence of epilepsy and no out-of-pocket payment requirements for health visits or medications. METHODS:We developed a 10-category survey to interview WWE ages 20-59 years in the Kingdom of Bhutan to understand their contraceptive use and peripartum experiences. WWE were recruited from 2016-2017 from an existing epilepsy cohort and their reproductive health data were merged with epilepsy and socioeconomic data obtained from initial clinical evaluations performed between 2014 and 2016. RESULTS:Of the 134 WWE eligible for the study, 94 were reachable and there was 1 refusal to participate (response rate 99% among reachable WWE; 69% of all WWE in the cohort). Of the 93 WWE (median age 27 years, range 20-52), 50 (54%) reported prior pregnancies. Of the entire cohort, 55 women responded on contraception: 26 (47%) WWE had never used contraception in their lifetime. Of the 29 WWE who had ever used contraception, the most commonly reported form was male condoms (14/29, 48%), followed by depot medroxyprogesterone acetate injections (13/29, 45%), and intrauterine devices (5/29, 17%). Sixty-three percent of WWE recalled receiving information on family planning (31 of 49). Of the 50 WWE with prior pregnancies, 37 of 46 (80%) used folic acid; 6 WWE reported commencing it in the first trimester while 29 WWE began supplementation in the second trimester. Primary school education or higher was associated with folic acid supplementation during pregnancy (26/29 vs. 11/17, p=0.040). Epilepsy affected at least one of the pregnancies in 38 of the cases (76%) with an average of 2.3 pregnancies per woman). There was a total of 86 pregnancies and an average inter-pregnancy interval of 3.5 years. Ninety-five percent of women attended prenatal care (36/38), 22% had at least one miscarriage (8/37), 14% had at least one pre-term delivery (5/36), and 21% had Caesarean sections (8/38). Seventeen of 38 (45%) of WWE had seizures during pregnancy. A majority of WWE (97%, 37 of 38) with a prior pregnancy reported breastfeeding their infant. CONCLUSIONS:Nearly half of Bhutanese WWE did not use contraception; among those who used it, male condoms were most common but 11% were at risk of potential drug-drug interactions between oral contraception and enzyme-inducing antiepileptic drugs. Bhutanese WWE had a high rate of prenatal visits. Folic acid was prescribed in most pregnant WWE but the majority began supplementation in the second trimester. The number of pregnancies in WWE in Bhutan (2.3 per woman) was comparable to the number of children per women in Bhutan (2.3). Breastfeeding was practiced almost universally. Points of intervention may include pre-conception initiation of folic acid, optimization of dosing of AEDs with contraceptives, guidelines for peripartum seizure treatment, and establishment of a prospective registry for WWE and their offspring.

Project description:Purpose:For thousands of years, fertility control has been used in different forms. This study was carried out to evaluate the knowledge and practice of participants regarding birth control methods with the prevalence of each method. Patients and Methods:A cross-sectional study design was employed to evaluate knowledge and practice among females. Three family-planning centers were included in addition to 2 general hospitals. A total of 440 married women between the ages of 18 and 40 years were interviewed by the first author. Self-administered version of a previously translated questionnaire was used to evaluate practice and knowledge concerning contraception use. Results:A total sample of 388 women of child-bearing age was interviewed. The mean age ± SD was 29.76 ± 6.67, while the mean number of their offspring was 4.06 ± 2.08. The intrauterine contraceptive device was the most frequently used method followed by oral contraceptive pills, while the safe-period method was the least frequently used. More than 50% of the females obtained their contraceptives from public health centers and/or hospitals. The mean number of contraception methods known by the females was 2.15 ± 1.07. Safety was the most indicated criterion for choosing the preferred method. Out of all the respondents, 86.9% indicated that they experience adverse effects from using contraceptive methods, in which a higher rate was for oral pills (31.1%), intrauterine contraceptive device (21.3%), or from both methods (18.4%). Conclusion:This study disclosed an acceptable level of knowledge and positive practices among Iraqi women seeking health-care facilities with respect to birth control methods. Females with lower levels of education require continued education and regular communication about the importance of birth control to promote the use of modern contraceptive methods. The findings from this study will help to develop programs that can improve knowledge of females and services provided by the health-care system and can reduce adverse effects from contraception and the incidence of unplanned pregnancies.

Dataset Information

Rheumatologists' knowledge of contraception, teratogens, and pregnancy risks.

Publications

Rheumatologists' knowledge of contraception, teratogens, and pregnancy risks.

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