Minority Women With Epilepsy Have Higher Rates of Unplanned Pregnancies vs Women Without Epilepsy
Women with epilepsy were less likely to breastfeed compared with healthy women.
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WASHINGTON, DC – Unplanned pregnancies are more common in women with epilepsy (WWE) than in women without epilepsy (WWoE), driven primarily by younger age, African American race, and lower socioeconomic status (SES), according to study findings presented at the 2017 American Epilepsy Society Annual Meeting December 1-5, 2017 in Washington, DC.
“Pregnancy planning is vital in WWE due to the risks of teratogenicity and harmful cognitive effects to the fetus of some antiepileptic medications (AEDs),” explained the investigators. “However, WWE are at risk of unintended pregnancy, as some AEDs increase the metabolism of hormonal contraceptives.”
In this study, investigators obtained data from the Pregnancy Risk Assessment Monitoring System (PRAMS) to evaluate the rates of unplanned pregnancies among WWE and WWoE. A total of 75,580 women, 548 of whom had epilepsy 3 months before their pregnancies, were included in the analysis.
There was a significantly greater proportion of unplanned pregnancies among WWE compared with WWoE (60.26% vs 51.23%, respectively; P <.001). Overall, WWE were of lower SES (P <.001) and younger (P =.001) than their WWoE counterparts.
Unplanned pregnancies were more common among younger WWE (odds ratio [OR] 1.21; 95% CI, 1.01-1.44) who were of lower SES (OR 3.84; 95% CI, 2.31-6.38). Additionally, WWE with unplanned pregnancies were also more likely to be African American than any other race (OR 2.31; 95% CI, 1.28-4.16; P <.05).
Epilepsy was not shown to be associated with pregnancy intention (OR 1.08; 95% CI, 0.87-1.35; P =.46). In addition, WWE received >110% of required or expected prenatal visits (OR 1.48; 95% CI, 1.16-1.90; P =.002) and were more likely to take a daily prenatal vitamin during pregnancy (OR 1.4; 95% CI, 1.13-1.78; P =.003).
Researchers found that WWE reported lower rates of breastfeeding than WWoE (68% vs 84% reported any breastfeeding, P <.001). “The proportion of women reporting breastfeeding is lower in WWE,” they noted, “despite studies indicating the safety of breastfeeding in WWE.”
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Johnson EL, Burke A, Pennell BP. Unintended pregnancy, prenatal care, and breastfeeding in women with epilepsy: results from the Pregnancy Risk Assessment Monitoring System (PRAMS). Presented at: 2017 American Epilepsy Society Annual Meeting. December 1-5, 2017; Washington, DC. Abstract 1.218.