Women with epilepsy have poorer knowledge and skills in child rearing than women without epilepsy

Epilepsy can negatively impact the child rearing ability of women because of the risk related to seizures, adverse effects of antiepileptic drugs and psychosocial factors.ObjectiveTo compare the child rearing knowledge (CRK) and practices (CRP) of women with epilepsy (WWE) with a matched group of women without epilepsy (WWoE).MethodologyThis study was carried out in the Kerala registry of epilepsy and pregnancy (KREP) at Sree Chitra Tirunal Institute for Medical Sciences and Technology in India. We prospectively recruited 100 WWE in first trimester of pregnancy from the KREP and 93 age, education and parity matched pregnant WWoE from the antenatal clinics of the Government medical college Thiruvananthapuram. Their child rearing knowledge (CRK) and practices (CRP) were evaluated with previously validated protocols. The CRK was assessed at the time of enrolment (first trimester of pregnancy) and the CRP was assessed when the baby was three to four months old.ResultsEighty-eight women each from WWE and WWoE had completed the study, over a period of three years. WWE and WWoE were comparable for age (25.56 ± 4.66 and 25.69 ± 4.49 years), pregnancy outcome and type of delivery. WWE had excess fetal loss and postnatal seizures. The CRK was significantly lower for WWE (23.53 ± 6.3) than for WWoE (26.08 ± 5.3). The CRP was significantly lower for WWE (25.01 ± 9.6) than for WWoE (28.14 ± 7.1). WWE performed poorer in all domains of child rearing practices namely feeding, growth and development, cleaning and protection and infant stimulation. Poorer CRK was strongly associated with lower CRP while several demographic and economic characteristics were not relevant. WWE fared poorer in feeding and nursing their babies in spite of having the right knowledge in that domain. This may be due to several undisclosed concerns and social dynamics that need to be addressed while preparing any interventions.