Prevalence of highly effective contraception use by women with epilepsy

Abstract

ObjectiveTo determine (1) the proportion of women with epilepsy (WWE) at risk of unintended pregnancy who use highly effective contraception, (2) demographic predictors, and (3) folic acid (FA) use.MethodsThese cross-sectional data come from 311 US WWE, 18–47 years, who participated in the Epilepsy Birth Control Registry (EBCR) web-based survey in 2017. They provided demographic, epilepsy, antiepileptic drug (AED), contraceptive, and FA data. We report frequencies of highly effective contraception use and use logistic regression to determine demographic predictors. We report the proportion who take FA.ResultsA total of 186 (59.8%) of the 311 WWE were at risk of unintended pregnancy. A total of 131 (70.4%) used a highly effective contraceptive category; 55 (29.6%) did not. An additional 13 (7.0%) used a combination of generally effective hormonal contraception with an enzyme-inducing AED, which poses increased risk of unintended pregnancy. Overall, 68 (36.6%) of the 186 WWE at risk did not use highly effective contraception. Increasing income (p = 0.004) and having insurance (p = 0.048) were predictors of highly effective contraception. A total of 50.0% took FA supplement. There was no significant difference in relation to the use or lack of use of highly effective contraception.ConclusionA total of 36.6% of WWE in the EBCR did not use highly effective contraception and 50.0% did not take FA in 2017 despite the important negative consequences of unintended pregnancy on pregnancy outcomes. There is a need for more readily available information and counseling on safe and effective contraception and FA use for this community.

Contraception, fecundity, and pregnancy in women with epilepsy: an update on recent literature

“…Nearly 30% did not use highly effective contraception methods and an additional 7% used hormonal contraception while on an enzyme-inducing antiseizure medication posing a risk of contraceptive failure. Older age, insurance coverage, and increased income were associated with highly effective contraceptive use [4]. This highlights the importance of counseling about contraception and pregnancy early.…”

“…Children exposed to antiseizure medication had increased risk of language impairment and delay but folic acid had a protective effect on language development [51,52 ]. Of note, the EBCR survey of more than 300 WWE found that only around 50% were taking folic acid [4]. Data from the NEAD study was retrospectively analyzed to evaluate if folic acid fortification in food was sufficient to increase childhood IQ.…”

“…Of note, the EBCR survey of more than 300 WWE found that only around 50% were taking folic acid [4]. Data from the NEAD study was retrospectively analyzed to evaluate if folic acid fortification in food was sufficient to increase childhood IQ.…”

Issues of Women with Epilepsy and Suitable Antiseizure Drugs

“…According to the Epilepsy Birth Control Registry’s web-based survey, 33.6% of WWE did not use highly effective contraception. 16 …”

Managing Transition of Care in Adolescent Females with Epilepsy

“…24 Studies have shown that there is a need for more education and increased awareness regarding highly effective contraceptive methods in WWE. 25 Emphasis should be laid on the selection of contraception through a shared decisionmaking process with focus on a method with minimal interactions with patients' medication regimen and one that does not risk an increase in seizure frequency. Adolescents should be offered preconceptual counseling early in the course, and continued education should be undertaken after transitioning to adult health care.…”