Unintended pregnancy, prenatal care, newborn outcomes, and breastfeeding in women with epilepsy

Emily Johnson, Anne E. Burke, Anqi Wang, Page B. Pennell

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: To compare the proportions of unintended pregnancies, prenatal vitamin or folic acid (PNVF) use, adequate prenatal care visits, and breastfeeding among women with epilepsy (WWE) to women without epilepsy (WWoE). METHODS: The Pregnancy Risk Assessment Monitoring System (PRAMS) is an annual survey of randomly sampled postpartum women administered by the Centers for Disease Control and Prevention. We used PRAMS data from 13 states from 2009 to 2014 to compare the primary outcomes in WWE and WWoE, as well as our secondary outcomes of contraception practices, newborn outcomes, and time to recognition of pregnancy. We adjusted for maternal age, race, ethnicity, and socioeconomic status (SES), and we calculated odds ratios for these outcomes using logistic regression. RESULTS: This analysis included 73,619 women, of whom 541 (0.7%) reported epilepsy, representing 3,442,128 WWoE and 26,635 WWE through weighted sampling. In WWE, 55% of pregnancies were unintended compared to 48% in WWoE. After adjustment for covariates, epilepsy was not associated with unintended pregnancy or with inadequate prenatal care. WWE were less likely to report breastfeeding but more likely to report daily PNVF use. Newborns of WWE had higher rates of prematurity. CONCLUSIONS: Although planning for pregnancy is of utmost importance for WWE, more than half the pregnancies in WWE were unintended. Maternal age and SES differences likely contribute to the higher rates in WWE compared to WWoE. The proportion of women reporting breastfeeding is lower in WWE despite studies indicating the safety of breastfeeding in WWE.

Original languageEnglish (US)
Pages (from-to)e1031-e1039
JournalNeurology
Volume91
Issue number11
DOIs
StatePublished - Sep 11 2018

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Prenatal Care
Breast Feeding
Epilepsy
Newborn Infant
Pregnancy
Maternal Age
Folic Acid
Social Class
Vitamins
Time-to-Pregnancy

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Unintended pregnancy, prenatal care, newborn outcomes, and breastfeeding in women with epilepsy. / Johnson, Emily; Burke, Anne E.; Wang, Anqi; Pennell, Page B.

In: Neurology, Vol. 91, No. 11, 11.09.2018, p. e1031-e1039.

Research output: Contribution to journalArticle

Johnson, Emily ; Burke, Anne E. ; Wang, Anqi ; Pennell, Page B. / Unintended pregnancy, prenatal care, newborn outcomes, and breastfeeding in women with epilepsy. In: Neurology. 2018 ; Vol. 91, No. 11. pp. e1031-e1039.
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