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Counselling on Conceiving: Attitudes and Factors Influencing Advice of Professionals in Transplantation

Pregnancy after kidney transplantation (KT) conveys risks of adverse pregnancy outcomes (APO). Little is known about performance of pre-pregnancy counselling after KT. This study investigated perceptions of risk, attitudes towards pregnancy and factors influencing advice given at pre-pregnancy couns...

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Autores principales: van Buren, Marleen C., Gosselink, Margriet, Massey, Emma K., van de Wetering, Jacqueline, Lely, A. Titia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10205991/
https://www.ncbi.nlm.nih.gov/pubmed/37234219
http://dx.doi.org/10.3389/ti.2023.11052
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author van Buren, Marleen C.
Gosselink, Margriet
Massey, Emma K.
van de Wetering, Jacqueline
Lely, A. Titia
author_facet van Buren, Marleen C.
Gosselink, Margriet
Massey, Emma K.
van de Wetering, Jacqueline
Lely, A. Titia
author_sort van Buren, Marleen C.
collection PubMed
description Pregnancy after kidney transplantation (KT) conveys risks of adverse pregnancy outcomes (APO). Little is known about performance of pre-pregnancy counselling after KT. This study investigated perceptions of risk, attitudes towards pregnancy and factors influencing advice given at pre-pregnancy counselling after KT. A web-based vignette survey was conducted among nephrologists and gynaecologists between March 2020 and March 2021, consisting of five vignettes containing known risk factors for APO and general questions on pre-pregnancy counselling after KT. Per vignette, attitudes towards pregnancy and estimation of outcomes were examined. In total 52 nephrologists and 25 gynaecologists participated, 56% from university hospitals. One third had no experience with pregnancy after KT. All gave positive pregnancy advice in the vignette with ideal circumstances (V1), versus 83% in V2 (proteinuria), 81% in V3 (hypertension), 71% in V4 (eGFR 40 ml/min/1.73 m(2)). Only 2% was positive in V5 (worst-case scenario). Chance of preeclampsia was underestimated by 89% in V1. 63% and 98% overestimated risk for graft loss in V4 and V5. Professionals often incorrectly estimated risk of APO after KT. As experience with pregnancy after KT was limited among professionals, patients should be referred to specialised centres for multidisciplinary pre-pregnancy counselling to build experience and increase consistency in given advice.
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spelling pubmed-102059912023-05-25 Counselling on Conceiving: Attitudes and Factors Influencing Advice of Professionals in Transplantation van Buren, Marleen C. Gosselink, Margriet Massey, Emma K. van de Wetering, Jacqueline Lely, A. Titia Transpl Int Health Archive Pregnancy after kidney transplantation (KT) conveys risks of adverse pregnancy outcomes (APO). Little is known about performance of pre-pregnancy counselling after KT. This study investigated perceptions of risk, attitudes towards pregnancy and factors influencing advice given at pre-pregnancy counselling after KT. A web-based vignette survey was conducted among nephrologists and gynaecologists between March 2020 and March 2021, consisting of five vignettes containing known risk factors for APO and general questions on pre-pregnancy counselling after KT. Per vignette, attitudes towards pregnancy and estimation of outcomes were examined. In total 52 nephrologists and 25 gynaecologists participated, 56% from university hospitals. One third had no experience with pregnancy after KT. All gave positive pregnancy advice in the vignette with ideal circumstances (V1), versus 83% in V2 (proteinuria), 81% in V3 (hypertension), 71% in V4 (eGFR 40 ml/min/1.73 m(2)). Only 2% was positive in V5 (worst-case scenario). Chance of preeclampsia was underestimated by 89% in V1. 63% and 98% overestimated risk for graft loss in V4 and V5. Professionals often incorrectly estimated risk of APO after KT. As experience with pregnancy after KT was limited among professionals, patients should be referred to specialised centres for multidisciplinary pre-pregnancy counselling to build experience and increase consistency in given advice. Frontiers Media S.A. 2023-05-10 /pmc/articles/PMC10205991/ /pubmed/37234219 http://dx.doi.org/10.3389/ti.2023.11052 Text en Copyright © 2023 van Buren, Gosselink, Massey, van de Wetering and Lely. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Health Archive
van Buren, Marleen C.
Gosselink, Margriet
Massey, Emma K.
van de Wetering, Jacqueline
Lely, A. Titia
Counselling on Conceiving: Attitudes and Factors Influencing Advice of Professionals in Transplantation
title Counselling on Conceiving: Attitudes and Factors Influencing Advice of Professionals in Transplantation
title_full Counselling on Conceiving: Attitudes and Factors Influencing Advice of Professionals in Transplantation
title_fullStr Counselling on Conceiving: Attitudes and Factors Influencing Advice of Professionals in Transplantation
title_full_unstemmed Counselling on Conceiving: Attitudes and Factors Influencing Advice of Professionals in Transplantation
title_short Counselling on Conceiving: Attitudes and Factors Influencing Advice of Professionals in Transplantation
title_sort counselling on conceiving: attitudes and factors influencing advice of professionals in transplantation
topic Health Archive
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10205991/
https://www.ncbi.nlm.nih.gov/pubmed/37234219
http://dx.doi.org/10.3389/ti.2023.11052
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