Abstracts

RATIONALE: The U.S. Department of Health and Human Services, Center for Disease Control, report unplanned pregnancies to be a problem in the United States. Since previous studies have suggested that women with epilepsy are at a higher risk of having children with birth defects or other perinatal complications, the implications of unplanned pregnancy in this group are potentially serious. This study examines the incidence of unplanned pregnancy in an epilepsy population and possible factors that might identify women at risk. METHODS: The medical records of women of child-bearing age were reviewed. 29 women were identified who had 34 pregnancies between 1991 and 2000. All women received pregnancy counseling at our center prior to pregnancy. Planned/unplanned pregnancy, age, marital status, educational background, and IQ were obtained. RESULTS: 24 (68%) of the pregnancies were unplanned. The mean age for women with planned pregnancies was 29 years and for unplanned pregnancies, 26.6 years. Age range was 19 to 34 years. The women with planned pregnancy were all married. 70% of the women with unplanned pregnancies were single. Mean years of education were 15.7 for women with planned pregnancy, 12.2 for women with unplanned pregnancy. Four of the nine women with planned pregnancies and 14 of the 20 women with unplanned pregnancies had neuropsychological testing. Mean IQ of planned pregnancy group was 102, while that of the unplanned pregnancy group was 91 (median 83). CONCLUSIONS: The incidence of unplanned pregnancy is high in this patient sample. This study found that unplanned pregnancy is associated with single marital status, 12 years or less of education and low average IQ. Married women with average IQ and post-high school education also had unplanned pregnancy. Despite receiving counseling in pregnancy planning, two thirds of our sample had unplanned pregnancies. These results have implications for the choice of anticonvulsants prescribed to women of child-bearing age.