Abstracts

Rationale: Women with Epilepsy: Pregnancy Outcomes and Deliveries (WEPOD) is a multicenter prospective observational study evaluating fertility among women with epilepsy (WWE) compared to healthy controls (HC). Since abnormal menstrual cycle length is associated with decreased fecundity, we sought to compare the length of menstrual cycles between the study groups. . Methods: WWE and HC aged 18-41 years planning pregnancy were enrolled within 6 months of stopping birth control. WEPOD utilizes a customized mobile electronic patient diary application designed by Irody. Daily diary input includes medications, seizures, sexual activity, and menstrual cycling, tracked as bleeding onset and offset. Subjects were trained to use the customized WEPOD App and were instructed to track daily until pregnancy confirmation or up to 12 months if they did not conceive. The data were analyzed to determine the distribution of days between the onsets of bleeding episodes. In this manner, menstrual cycle length was determined. The median menstrual cycle length, and the number of cycles shorter or longer than what is considered a normal menstrual cycle length (21 days - 35 days) was compared across groups. . Results: Ninety WWE and 109 HC were enrolled in the study. The mean age was 32 years in each group. Patient demographics are presented in Table 1. Data were analyzed on 81 WWE and 96 HC. Adjusting for days of tracking per group, the median number of days between menstrual onsets was 25 in WWE and 26 in HC (difference NS). The total numbers of menstrual cycles captured were 465 for WWE and 682 for HC. The number of menstrual cycles that were shorter than 21 days was 145 (31.2%) in WWE and 198 (29.0%) in HC subjects. The number of menstrual cycles that were longer than 35 days was 35 (7.5%) in WWE and 56 (8.2%) in HC subjects. Generalized Estimating Equations (GEE) with a logit link was used to analyze the number of normal length menstrual cycles, abnormally long and abnormally short menstrual cycles across groups. The p-values for the three categories were not significant at 0.7037, 0.7761, and 0.5461, respectively. Conclusions: These preliminary findings of WWE enrolled in the WEPOD study demonstrate normal menstrual cycle lengths compared to HC. This favorable finding may be influenced by the characteristic of relatively well-controlled epilepsy in this cohort of women seeking planned pregnancy. Future analyses will include ovulatory rates and time to conception, as well as analyses stratified by seizure frequency, epilepsy syndromes, and AEDs prescribed. This study was sponsored by the Epilepsy Therapy Project.