In the general population, the researchers noted, hormonal contraception is considered highly effective. However, the efficacy of hormonal contraceptives may be compromised in WWE who take AEDs associated with enzyme-inducing effects.
In the current study, Dr Herzog and colleagues analyzed retrospective data from the EBCR to examine associations between AED and contraceptive combinations used with rates of unintended pregnancy in WWE.
The EBCR contained data on 1144 WWE age 18 to 47 that provided information on demographics, contraceptive and AED use, epilepsy, and pregnancy on a web-based survey. The investigators categorized AEDs based on enzyme-inducing potential and contraceptives as hormonal or non-hormonal.
In total, 345 participants reported at least 1 unintended pregnancy (345/437, 78.9%), and 65% of all pregnancies were unintended (523/804). Participants age 38 to 47 had the lowest rate of unintended pregnancy (relative risk [RR]: 1.48), whereas participants younger than 18 or age 18 to 27 had higher rates of unintended pregnancy (RR: 2.03 and 1.63, respectively, P <.0001 for both). The rate of unintended pregnancy was higher in minority and Hispanic participants compared with whites and non-Hispanics (RR: 1.22, P =.005 and RR: 1.24, P =.002, respectively).