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.”