title: Contraceptive practices of women with epilepsy: Findings of the epilepsy birth control registry.
abstract: OBJECTIVE
  To report the contraceptive practices of women with epilepsy (WWE) in the community, predictors of highly effective contraception use, and reasons WWE provide for the selection of a particular method.
  
  
  METHODS
  These cross-sectional data come from the Epilepsy Birth Control Registry (EBCR) web-based survey regarding the contraceptive practices of 1,144 WWE in the community, ages 18-47 years. We report demographic, epilepsy, and antiepileptic drug (AED) characteristics as well as contraceptive use. We determined the frequency of use of highly effective contraception use, that is, methods with failure rate <10%/year, and conducted binary logistic regression analysis to determine predictors of highly effective contraception use. We report frequencies of WWE who consult various health care providers regarding the selection of a method and the reasons cited for selection.
  
  
  RESULTS
  Of the 796 WWE at risk of unintended pregnancy, 69.7% use what is generally considered to be highly effective contraception (hormonal, intrauterine device [IUD], tubal, vasectomy). Efficacy in WWE, especially for the 46.6% who use hormonal contraception, remains to be proven. Significant predictors of highly effective contraception use are insurance (insured 71.6% vs. noninsured 56.0%), race/ethnicity (Caucasian 71.3% vs. minority 51.0%), and age (38-47, 77.5%; 28-37, 71.8%; 18-27, 67.0%). Of the 87.2% who have a neurologist, only 25.4% consult them regarding selection of a method, although AED interaction is cited as the top reason for selection.
  
  
  CONCLUSIONS
  The EBCR web-based survey is the first large-scale study of the contraceptive practices of WWE in the community. The findings suggest a need for the development of evidence-based guidelines that address the efficacy and safety of contraceptive methods in this special population, and for greater discourse between neurologists and WWE regarding contraception.
authors.affiliation: Harvard Neuroendocrine Unit, Beth Israel Deaconess Medical Center, Boston, Massachusetts, U.S.A.
authors.forename: Andrew G
authors.initials: AG
authors.lastname: Herzog
authors.affiliation: Harvard Neuroendocrine Unit, Beth Israel Deaconess Medical Center, Boston, Massachusetts, U.S.A.
authors.forename: Hannah B
authors.initials: HB
authors.lastname: Mandle
authors.affiliation: Harvard Neuroendocrine Unit, Beth Israel Deaconess Medical Center, Boston, Massachusetts, U.S.A.
authors.forename: Kaitlyn E
authors.initials: KE
authors.lastname: Cahill
authors.affiliation: Harvard Neuroendocrine Unit, Beth Israel Deaconess Medical Center, Boston, Massachusetts, U.S.A.
authors.forename: Kristen M
authors.initials: KM
authors.lastname: Fowler
authors.affiliation: Gertrude H. Sergievsky Center, Mailman School of Public Health, Columbia University, New York, New York, U.S.A.
authors.forename: W Allen
authors.initials: WA
authors.lastname: Hauser
authors.affiliation: Department of OBGYN, Columbia University Medical Center, New York, New York, U.S.A.
authors.forename: Anne R
authors.initials: AR
authors.lastname: Davis
mesh_terms: D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000008:administration & dosage* / Q000009:adverse effects; D003267:Contraception / Q000379:methods* / Q000639:trends; D003270:Contraceptive Agents / Q000008:administration & dosage*; D003430:Cross-Sectional Studies; D004827:Epilepsy / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011247:Pregnancy; D012042:Registries; D055815:Young Adult
chemical_list: D000927:Anticonvulsants; D003270:Contraceptive Agents
keywords: Contraception; Epidemiology; Epilepsy; Seizures; Women