Skip to main content
Advertisement
  • Neurology.org
  • Journals
    • Neurology
    • Clinical Practice
    • Education
    • Genetics
    • Neuroimmunology & Neuroinflammation
  • Online Sections
    • Neurology Video Journal Club
    • Diversity, Equity, & Inclusion (DEI)
    • Innovations in Care Delivery
    • Practice Buzz
    • Practice Current
    • Residents & Fellows
    • Without Borders
  • Collections
    • COVID-19
    • Disputes & Debates
    • Health Disparities
    • Infographics
    • Neurology Future Forecasting Series
    • Null Hypothesis
    • Patient Pages
    • Topics A-Z
    • Translations
  • Podcast
  • CME
  • About
    • About the Journals
    • Contact Us
    • Editorial Board
  • Authors
    • Submit New Manuscript
    • Submit Revised Manuscript
    • Author Center

Advanced Search

Main menu

  • Neurology.org
  • Journals
    • Neurology
    • Clinical Practice
    • Education
    • Genetics
    • Neuroimmunology & Neuroinflammation
  • Online Sections
    • Neurology Video Journal Club
    • Diversity, Equity, & Inclusion (DEI)
    • Innovations in Care Delivery
    • Practice Buzz
    • Practice Current
    • Residents & Fellows
    • Without Borders
  • Collections
    • COVID-19
    • Disputes & Debates
    • Health Disparities
    • Infographics
    • Neurology Future Forecasting Series
    • Null Hypothesis
    • Patient Pages
    • Topics A-Z
    • Translations
  • Podcast
  • CME
  • About
    • About the Journals
    • Contact Us
    • Editorial Board
  • Authors
    • Submit New Manuscript
    • Submit Revised Manuscript
    • Author Center
  • Home
  • Latest Articles
  • Current Issue
  • Past Issues
  • Neurology Video Journal Club
  • Residents & Fellows

User menu

  • Subscribe
  • My Alerts
  • Log in

Search

  • Advanced search
Neurology
Home
The most widely read and highly cited peer-reviewed neurology journal
  • Subscribe
  • My Alerts
  • Log in
Site Logo
  • Home
  • Latest Articles
  • Current Issue
  • Past Issues
  • Neurology Video Journal Club
  • Residents & Fellows

Share

February 21, 2017; 88 (8) Article

Predictors of unintended pregnancy in women with epilepsy

Andrew G. Herzog, Hannah B. Mandle, Kaitlyn E. Cahill, Kristen M. Fowler, W. Allen Hauser
First published January 25, 2017, DOI: https://doi.org/10.1212/WNL.0000000000003637
Andrew G. Herzog
From the Harvard Neuroendocrine Unit (A.G.H., H.B.M., K.E.C., K.M.F.), Beth Israel Deaconess Medical Center, Boston, MA; and the Gertrude H. Sergievsky Center (W.A.H.), Mailman School of Public Health, Columbia University, New York, NY.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Hannah B. Mandle
From the Harvard Neuroendocrine Unit (A.G.H., H.B.M., K.E.C., K.M.F.), Beth Israel Deaconess Medical Center, Boston, MA; and the Gertrude H. Sergievsky Center (W.A.H.), Mailman School of Public Health, Columbia University, New York, NY.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Kaitlyn E. Cahill
From the Harvard Neuroendocrine Unit (A.G.H., H.B.M., K.E.C., K.M.F.), Beth Israel Deaconess Medical Center, Boston, MA; and the Gertrude H. Sergievsky Center (W.A.H.), Mailman School of Public Health, Columbia University, New York, NY.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Kristen M. Fowler
From the Harvard Neuroendocrine Unit (A.G.H., H.B.M., K.E.C., K.M.F.), Beth Israel Deaconess Medical Center, Boston, MA; and the Gertrude H. Sergievsky Center (W.A.H.), Mailman School of Public Health, Columbia University, New York, NY.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
W. Allen Hauser
From the Harvard Neuroendocrine Unit (A.G.H., H.B.M., K.E.C., K.M.F.), Beth Israel Deaconess Medical Center, Boston, MA; and the Gertrude H. Sergievsky Center (W.A.H.), Mailman School of Public Health, Columbia University, New York, NY.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Full PDF
Citation
Predictors of unintended pregnancy in women with epilepsy
Andrew G. Herzog, Hannah B. Mandle, Kaitlyn E. Cahill, Kristen M. Fowler, W. Allen Hauser
Neurology Feb 2017, 88 (8) 728-733; DOI: 10.1212/WNL.0000000000003637

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Permissions

Make Comment

See Comments

Downloads
342

Share

  • Article
  • Figures & Data
  • Info & Disclosures
Loading

This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.

Abstract

Objective: To determine whether rates of unintended pregnancy in women with epilepsy (WWE) vary by contraceptive category and when stratified by antiepileptic drug (AED) category.

Methods: These retrospective data come from the Epilepsy Birth Control Registry (EBCR) web-based survey of 1,144 WWE in the community, 18–47 years of age, who provided demographic, epilepsy, AED, contraceptive, and pregnancy data. Participants indicated whether pregnancies were intended or unintended, as well as the type of contraceptive and AED used at conception. We report failure rates relative to the frequency of use of each contraceptive category in the EBCR.

Results: Most WWE (78.9%) reported having at least one unintended pregnancy; 65.0% of their pregnancies were unintended. Unintended pregnancy was more common among younger, racial minority, and Hispanic WWE. Among reversible contraceptive categories, the intrauterine device had the lowest failure rate. Failure rates varied greatly on systemic hormonal contraception (HC), depending on whether oral or nonoral forms were used and especially in relation to the category of AED with which HC was combined. Oral forms had greater failure rate than nonoral forms. HC combined with enzyme-inducing AEDs had a substantially greater failure rate than HC combined with no AED or any other AED category and in comparison to barrier plus any AED category. Other AED–HC combinations, in contrast, carried lower risks than barrier.

Conclusions: Unintended pregnancy is common among WWE and may vary by contraceptive category and AED stratification. In view of the important consequences of unintended pregnancy on pregnancy outcomes, these retrospective findings warrant further prospective investigation.

GLOSSARY

AED=
antiepileptic drug;
CI=
confidence interval;
COCP=
combination oral contraceptive pill;
DMPA=
depomedroxyprogesterone acetate;
EBCR=
Epilepsy Birth Control Registry;
EIAED=
enzyme-inducing antiepileptic drug;
GluAED=
glucuronidated antiepileptic drug;
HC=
hormonal contraception;
InhAED=
enzyme-inhibiting antiepileptic drug;
IUD=
intrauterine device;
NEIAED=
non-enzyme-inducing antiepileptic drug;
NHC=
nonhormonal contraception;
POCP=
progestin-only oral contraceptive pill;
RR=
risk ratio;
WWE=
women with epilepsy

Footnotes

  • Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

  • Editorial, page 724

  • Received July 10, 2016.
  • Accepted in final form November 16, 2016.
  • © 2017 American Academy of Neurology
View Full Text

AAN Members

We have changed the login procedure to improve access between AAN.com and the Neurology journals. If you are experiencing issues, please log out of AAN.com and clear history and cookies. (For instructions by browser, please click the instruction pages below). After clearing, choose preferred Journal and select login for AAN Members. You will be redirected to a login page where you can log in with your AAN ID number and password. When you are returned to the Journal, your name should appear at the top right of the page.

Google Safari Microsoft Edge Firefox

Click here to login

AAN Non-Member Subscribers

Click here to login

Purchase access

For assistance, please contact:
AAN Members (800) 879-1960 or (612) 928-6000 (International)
Non-AAN Member subscribers (800) 638-3030 or (301) 223-2300 option 3, select 1 (international)

Sign Up
Information on how to subscribe to Neurology and Neurology: Clinical Practice can be found here 

Purchase
Individual access to articles is available through the Add to Cart option on the article page.  Access for 1 day (from the computer you are currently using) is US$ 39.00.  Pay-per-view content is for the use of the payee only, and content may not be further distributed by print or electronic means.  The payee may view, download, and/or print the article for his/her personal, scholarly, research, and educational use.  Distributing copies (electronic or otherwise) of the article is not allowed.

Letters: Rapid online correspondence

No comments have been published for this article.
Comment

REQUIREMENTS

If you are uploading a letter concerning an article:
You must have updated your disclosures within six months: http://submit.neurology.org

Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.

If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.

Submission specifications:

  • Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
  • Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
  • Submit only on articles published within 6 months of issue date.
  • Do not be redundant. Read any comments already posted on the article prior to submission.
  • Submitted comments are subject to editing and editor review prior to posting.

More guidelines and information on Disputes & Debates

Compose Comment

More information about text formats

Plain text

  • No HTML tags allowed.
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.
Author Information
NOTE: The first author must also be the corresponding author of the comment.
First or given name, e.g. 'Peter'.
Your last, or family, name, e.g. 'MacMoody'.
Your email address, e.g. higgs-boson@gmail.com
Your role and/or occupation, e.g. 'Orthopedic Surgeon'.
Your organization or institution (if applicable), e.g. 'Royal Free Hospital'.
Publishing Agreement
NOTE: All authors, besides the first/corresponding author, must complete a separate Publishing Agreement Form and provide via email to the editorial office before comments can be posted.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.

Vertical Tabs

You May Also be Interested in

Back to top
  • Article
    • Abstract
    • GLOSSARY
    • METHODS
    • RESULTS
    • DISCUSSION
    • AUTHOR CONTRIBUTIONS
    • STUDY FUNDING
    • DISCLOSURE
    • Footnotes
    • REFERENCES
  • Figures & Data
  • Info & Disclosures
Advertisement

SARS-CoV-2 Vaccination Safety in Guillain-Barré Syndrome, Chronic Inflammatory Demyelinating Polyneuropathy, and Multifocal Motor Neuropathy

Dr. Jeffrey Allen and Dr. Nicholas Purcell

► Watch

Related Articles

  • Epilepsy and unintended pregnancies

Topics Discussed

  • All Health Services Research
  • All Epilepsy/Seizures
  • All epidemiology
  • Antiepileptic drugs

Alert Me

  • Alert me when eletters are published

Recommended articles

  • Article
    Prevalence of highly effective contraception use by women with epilepsy
    Andrew G. Herzog, Hannah B. Mandle, Devon B. MacEachern et al.
    Neurology, May 17, 2019
  • Articles
    Antiepileptic drugs and hormonal contraceptives in adolescent women with epilepsy
    Mary L. Zupanc et al.
    Neurology, March 27, 2006
  • Articles
    An overview of oral contraceptives
    Mechanism of action and clinical use
    Cheryl A. Frye et al.
    Neurology, March 27, 2006
  • Article
    Unintended pregnancy, prenatal care, newborn outcomes, and breastfeeding in women with epilepsy
    Emily L. Johnson, Anne E. Burke, Anqi Wang et al.
    Neurology, August 10, 2018
Neurology: 100 (13)

Articles

  • Ahead of Print
  • Current Issue
  • Past Issues
  • Popular Articles
  • Translations

About

  • About the Journals
  • Ethics Policies
  • Editors & Editorial Board
  • Contact Us
  • Advertise

Submit

  • Author Center
  • Submit a Manuscript
  • Information for Reviewers
  • AAN Guidelines
  • Permissions

Subscribers

  • Subscribe
  • Activate a Subscription
  • Sign up for eAlerts
  • RSS Feed
Site Logo
  • Visit neurology Template on Facebook
  • Follow neurology Template on Twitter
  • Visit Neurology on YouTube
  • Neurology
  • Neurology: Clinical Practice
  • Neurology: Education
  • Neurology: Genetics
  • Neurology: Neuroimmunology & Neuroinflammation
  • AAN.com
  • AANnews
  • Continuum
  • Brain & Life
  • Neurology Today

Wolters Kluwer Logo

Neurology | Print ISSN:0028-3878
Online ISSN:1526-632X

© 2023 American Academy of Neurology

  • Privacy Policy
  • Feedback
  • Advertise