Abstract：
OBJECTIVE: In this study, we aimed to characterize practice patterns of neurologists and obstetricians in breastfeeding (BF) counseling in women with epilepsy (WWE) and explore factors that may influence physician counseling behaviors.
METHODS: We conducted a cross-sectional study of neurologists and obstetricians via an anonymous survey from September 2021 until November 2021. A survey was developed to explore the following areas in WWE: current physicians\' BF counseling patterns, physician-specific factors affecting BF counseling, and patient-specific factors and their impact on BF counseling. Descriptive statistics were generated for each survey question. Responses from neurologists and obstetricians were compared. Odds ratios (OR) and confidence intervals (CI) were calculated to assess factors that influence BF counseling in WWE.
RESULTS: A total of 185 physicians participated in the study and consisted of 91 (49.2 %) neurologists, 83 (44.8 %) obstetricians, and 11 (6 %) participants from other specialties. Ninety-four percent (94 %) of neurologists and 92 % of obstetricians indicated that they provide BF safety counseling to WWE primarily during preconception and occasionally during pregnancy. Fifty-six percent of obstetricians reported being very comfortable with BF counseling in WWE, compared to 68 % of neurologists. Both groups rated research and clinical practice guidelines as two factors that have major impact on BF counseling; however, less than half (45 %) of neurologists are very familiar with the current literature and only a quarter (24 %) of obstetricians are very familiar with current literature regarding safety of BF in WWE. Regarding barriers to BF counseling, relative to neurologists, obstetricians believe that delivery of conflicting opinions among medical specialists about BF safety is a barrier that may impede effective BF counseling in WWE [OR = 2.78 (95 % CI: 1.30,5.95), adjusted p value (P = 0.008)].
CONCLUSIONS: Variable knowledge of current literature in BF in WWE and low comfort levels in BF counseling among various specialists, as well as perceived inadequate data and clinical practice guidelines, may contribute to suboptimal BF counseling and impact health outcomes in WWE and their children.
METHODS: We conducted a cross-sectional study of neurologists and obstetricians via an anonymous survey from September 2021 until November 2021. A survey was developed to explore the following areas in WWE: current physicians\' BF counseling patterns, physician-specific factors affecting BF counseling, and patient-specific factors and their impact on BF counseling. Descriptive statistics were generated for each survey question. Responses from neurologists and obstetricians were compared. Odds ratios (OR) and confidence intervals (CI) were calculated to assess factors that influence BF counseling in WWE.
RESULTS: A total of 185 physicians participated in the study and consisted of 91 (49.2 %) neurologists, 83 (44.8 %) obstetricians, and 11 (6 %) participants from other specialties. Ninety-four percent (94 %) of neurologists and 92 % of obstetricians indicated that they provide BF safety counseling to WWE primarily during preconception and occasionally during pregnancy. Fifty-six percent of obstetricians reported being very comfortable with BF counseling in WWE, compared to 68 % of neurologists. Both groups rated research and clinical practice guidelines as two factors that have major impact on BF counseling; however, less than half (45 %) of neurologists are very familiar with the current literature and only a quarter (24 %) of obstetricians are very familiar with current literature regarding safety of BF in WWE. Regarding barriers to BF counseling, relative to neurologists, obstetricians believe that delivery of conflicting opinions among medical specialists about BF safety is a barrier that may impede effective BF counseling in WWE [OR = 2.78 (95 % CI: 1.30,5.95), adjusted p value (P = 0.008)].
CONCLUSIONS: Variable knowledge of current literature in BF in WWE and low comfort levels in BF counseling among various specialists, as well as perceived inadequate data and clinical practice guidelines, may contribute to suboptimal BF counseling and impact health outcomes in WWE and their children.
摘要：
目的：在本研究中，我们旨在描述神经科医师和产科医生在女性癫痫患者(WWE)母乳喂养(BF)咨询中的实践模式,并探讨可能影响医师咨询行为的因素.
方法：我们从2021年9月至2021年11月通过匿名调查对神经科医生和妇产科医生进行了横断面研究。进行了一项调查，以探索WWE的以下领域：当前的医生\'BF咨询模式，影响BF咨询的医生特定因素，患者特异性因素及其对BF咨询的影响。为每个调查问题生成描述性统计数据。比较了神经科医生和产科医生的反应。计算赔率比（OR）和置信区间（CI）以评估WWE中影响BF咨询的因素。
结果：共有185名医生参与了这项研究，由91名（49.2%）神经科医生组成，83名(44.8%)产科医生，11名(6%)来自其他专业的参与者。94％（94％）的神经科医生和92％的产科医生表示，他们主要在孕前和怀孕期间为WWE提供BF安全咨询。56％的产科医生报告说在WWE中对BF咨询非常满意，相比之下，68%的神经科医生。两组都将研究和临床实践指南列为对BF咨询有重大影响的两个因素；然而，不到一半(45%)的神经科医师非常熟悉现有文献,只有四分之一(24%)的产科医生非常熟悉WWE中关于BF安全性的现有文献.关于BF咨询的障碍，相对于神经学家，产科医生认为，医学专家之间关于BF安全性的相互矛盾的意见是一个障碍，可能会阻碍WWE中有效的BF咨询[OR=2.78（95％CI：1.30,5.95），调整后的p值(P=0.008)]。
结论：WWE中BF现有文献的可变知识以及各种专家在BF咨询中的低舒适度，以及感知到的不足的数据和临床实践指南，可能会导致欠佳的BF咨询，并影响WWE及其子女的健康结果。
方法：我们从2021年9月至2021年11月通过匿名调查对神经科医生和妇产科医生进行了横断面研究。进行了一项调查，以探索WWE的以下领域：当前的医生\'BF咨询模式，影响BF咨询的医生特定因素，患者特异性因素及其对BF咨询的影响。为每个调查问题生成描述性统计数据。比较了神经科医生和产科医生的反应。计算赔率比（OR）和置信区间（CI）以评估WWE中影响BF咨询的因素。
结果：共有185名医生参与了这项研究，由91名（49.2%）神经科医生组成，83名(44.8%)产科医生，11名(6%)来自其他专业的参与者。94％（94％）的神经科医生和92％的产科医生表示，他们主要在孕前和怀孕期间为WWE提供BF安全咨询。56％的产科医生报告说在WWE中对BF咨询非常满意，相比之下，68%的神经科医生。两组都将研究和临床实践指南列为对BF咨询有重大影响的两个因素；然而，不到一半(45%)的神经科医师非常熟悉现有文献,只有四分之一(24%)的产科医生非常熟悉WWE中关于BF安全性的现有文献.关于BF咨询的障碍，相对于神经学家，产科医生认为，医学专家之间关于BF安全性的相互矛盾的意见是一个障碍，可能会阻碍WWE中有效的BF咨询[OR=2.78（95％CI：1.30,5.95），调整后的p值(P=0.008)]。
结论：WWE中BF现有文献的可变知识以及各种专家在BF咨询中的低舒适度，以及感知到的不足的数据和临床实践指南，可能会导致欠佳的BF咨询，并影响WWE及其子女的健康结果。
