July 1, 2019

Improved Counseling Needed for Safe, Effective Contraception in Women With Epilepsy

Despite the important negative consequences of unintended pregnancy such as elevated risk of having offspring with congenital malformations, over a third of women with epilepsy do not use highly effective contraception, according to a study published in Neurology.

In this cross-sectional study, investigators analyzed data from the Epilepsy Birth Control Registry online survey data collected in 2017 by women with epilepsy aged between 18 and 47 years (n=311). Data included demographics, epilepsy classification, antiepileptic drug use, reproductive status, and contraceptive habits.

Among women with epilepsy at risk for pregnancy 29.6% used no highly effective contraceptive (n=55), including no birth control (2.2% [n=4]), withdrawal method (4.3% [n=8]), or barrier only (23.1% [n=43]).

In sum, 36.6% of women with epilepsy (n=68; 95% CI, 30%-43.7%) were not using highly effective contraception. No significant difference between the use (or lack of use) of highly effective contraceptives was found.

Of note, only 50% of women with epilepsy at risk for unintended pregnancy (regardless of contraception use) were taking a prenatal folic acid supplement as part of their treatment regimen, despite practice guidelines emphasizing its importance in maximizing maternal and fetal outcomes.

The investigators concluded that “[t]here is a need for more readily available information and counseling on safe and effective contraception and [folic acid] use for this community.”

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