A study found that 30% of women with epilepsy did not use highly effective contraception though they are at an increased risk of having babies with fetal malformations due to their antiepileptic medications. Findings from the study are published in Epilepsia.

Using cross-sectional data from the Epilepsy Birth Control Registry (EBCR) web-based survey, study authors analyzed 1,144 women with epilepsy aged 18 to 47 years. They looked at the frequency of highly effective contraception use, defined as having a failure rate <10% per year, and they conducted regression analysis to identify predictors of highly effective contraception use. 

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Of the total women with epilepsy at risk of unintended pregnancy (n=796), 69.7% used highly effective contraception which includes hormonal, intrauterine device, tubal, and vasectomy. Efficacy in women with epilepsy who use hormonal contraception (46.6%) has yet to be proven. 

Other predictors of highly effective contraception use included Caucasian (71.3%), older women aged 38 to 47 years (77.5%), and those who were insured (71.6%). In addition, only 25.4% of the 87.52% of women who have a neurologist consulted them regarding method selection. 

Study findings encourage the need for development of evidence-based guidelines that address safety and efficacy of contraceptive method in women with epilepsy and for increased dialogue between neurologists and this patient population regarding contraception.

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